Organization Active NPI

Med-Trans Corporation

  • Air Ambulance
  • Douglas, AZ
National Provider Identifier
1518983774
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Air AmbulanceTaxonomy code 3416A0800X
Legal business name
MED-TRANS CORPORATION
Practice address
3200 E 10TH St
Douglas, AZ 85607-2745
Phone
(877) 288-5340
NPI assigned
Jul 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eric Thomas
Title
SVP of Revenue Management
Phone
(877) 288-5340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Air Ambulance 3416A0800X Primary

Addresses

Primary practice location

3200 E 10TH St
Douglas, AZ 85607-2745

Mailing address

PO Box 708
West Plains, MO 65775-0708
Phone (877) 288-5340

Other names 1

  • Arizona LifeLine II Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040223000975 AZ Part B Supplier - Ambulance Service Supplier 8921904145 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Casa Grande, AZ; Douglas, AZ; Saint David, AZ

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Med Star117 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

3200 E 10th St
Douglas, AZ 85607
Phone (520) 805-1412

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1518983774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657750708",
            "telephone_number": "877-288-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 E 10TH ST",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856072745",
            "telephone_number": "877-288-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-TRANS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "SVP OF REVENUE MANAGEMENT",
        "authorized_official_telephone_number": "877-288-5340"
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona LifeLine II",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Arizona LifeLine II",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Douglas, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.