Air Evac EMS Inc
Organization Active NPI Air Ambulance · Poplar Bluff, MO
NPI 1194708909 · NPPES record last updated Aug 3, 2018
Key facts
- NPI
- 1194708909
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Air Ambulance 3416A0800X
- Legal business name
- AIR EVAC EMS INC
- Practice address
- 2979 Highway B
Poplar Bluff, MO 63901 - Phone
- (573) 274-2082
- Fax
- (573) 778-1417
- NPI assigned
- Nov 25, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- AIR EVAC EMS INC
Authorized official
- Name
- Eric Thomas
- Title
- SRVP of Revenue Management
- Phone
- (877) 288-5340
Other NPIs on the same Medicare enrollment 32
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031119000681 | TN | Part B Supplier - Ambulance Service Supplier | 8123931755 |
18 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lafayette, TN; Waynesboro, TN; Waverly, TN; Troy, TN; Smyrna, TN; Savannah, TN; Parsons, TN; Paris, TN… |
| O20040517001091 | MO | Part B Supplier - Ambulance Service Supplier | 8123931755 |
14 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Salem, MO; Poplar Bluff, MO; Sedalia, MO; Sikeston, MO; Sullivan, MO; Troy, MO; West Plains, MO; Kirksville, MO… |
National Provider Directory
- Part of
- Lifeteam Midwest Ae20
Locations
2979 Highway B
Poplar Bluff, MO 63901
Phone (573) 274-2082
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Air Ambulance | 3416A0800X | Yes |
Addresses
Primary practice location
2979 Highway B
Poplar Bluff, MO 63901
Mailing address
PO Box 106
West Plains, MO 65775-0106
Phone (417) 257-1585
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AEL-20 POPLAR BLUFF | Other | BASE ID |
Other names
- Air Evac Lifeteam
Other providers in Poplar Bluff, MO
- Advanced Pharmacy
- Advanced Therapy Services, LLC
- Muhammad Saad Ahmad
- Bisma Ahsan
- Air Evac EMS Inc
- Donna D Akers
- Tirso J Aldana
- Kristen M Alexander-Frey
- Mohanad Ali Alfaqih
- Ali Ahsan Ali
All providers in Poplar Bluff, MO · Air Ambulance in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2018. 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.