Air Evac EMS, Inc.
Organization Active NPI Air Ambulance · Portland, IN
NPI 1801428362 · NPPES record last updated Mar 11, 2020
Key facts
- NPI
- 1801428362
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Air Ambulance 3416A0800X
- Legal business name
- AIR EVAC EMS, INC.
- Practice address
- 647 W 100 N
Portland, IN 47371-8071 - Phone
- (877) 288-5340
- Fax
- (417) 257-5761
- NPI assigned
- Feb 12, 2020
- 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 6
Corporate family (same tax ID) 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040831001139 | IN | Part B Supplier - Ambulance Service Supplier | 8123931755 |
6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Knox, IN; Wabash, IN; Portland, IN; Paoli, IN; Brazil, IN; Evansville, IN |
National Provider Directory
- Tax ID family
- Lifeteam Midwest Ae20
- Part of
- Lifeteam Midwest Ae20
Locations
441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577
647 W 100 N
Portland, IN 47371
Phone (260) 766-4493
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Air Ambulance | 3416A0800X | Yes |
Addresses
Primary practice location
647 W 100 N
Portland, IN 47371-8071
Mailing address
PO Box 106
West Plains, MO 65775-0106
Phone (877) 288-5340
Other names
- Lutheran Health
Other providers in Portland, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 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.