Air Evac EMS, Inc.
Organization Active NPI Air Ambulance · Mattoon, IL
NPI 1124555693 · NPPES record last updated Mar 9, 2020
Key facts
- NPI
- 1124555693
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Air Ambulance 3416A0800X
- Legal business name
- AIR EVAC EMS, INC.
- Practice address
- 7894 N County Road 1050E
Mattoon, IL 61938-8523 - Phone
- (877) 288-5340
- Fax
- (417) 257-5761
- NPI assigned
- May 16, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- AIR EVAC EMS, INC.
Authorized official
- Name
- Eric Thomas
- Title
- SVP of Revenue Management
- Phone
- (877) 288-5340
Other NPIs on the same Medicare enrollment 13
Corporate family (same tax ID) 12
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040310000107 | IL | Part B Supplier - Ambulance Service Supplier | 8123931755 |
13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mount Vernon, IL; Watson, IL; Quincy, IL; Olney, IL; Mattoon, IL; Marion, IL; Maryville, IL; Greenville, IL… |
National Provider Directory
- Tax ID family
- Lifeteam Midwest Ae20
- Part of
- Lifeteam Midwest Ae20
Locations
7894 N County Road 1050E
Mattoon, IL 61938
Phone (217) 234-4342
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Air Ambulance | 3416A0800X | Yes |
Addresses
Primary practice location
7894 N County Road 1050E
Mattoon, IL 61938-8523
Mailing address
PO Box 106
West Plains, MO 65775-0106
Phone (877) 288-5340
Other names
- Air Evac Lifeteam
Other providers in Mattoon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.