Organization
GALLUP MED FLIGHT, LLC
Active
Organization
GALLUP MED FLIGHT, LLC
Active
Other names
Gallup Med Flight
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC THOMAS (SVP OF REVENUE MANAGEMENT)
(877) 288-5340
Entity
Organization
Contact information
Practice address
2111 W HISTORIC HIGHWAY 66, GALLUP, NM 87301
(801) 619-4900
(801) 619-8077
Mailing address
10888 S 300 W, SOUTH JORDAN, UT 84095-4043
(801) 619-4900
(801) 619-8077
Taxonomy
Speciality
Code
Description
License number
State
3416A0800X
Air Ambulance
Primary
06-00000788
NM
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0551606
—
IA
05
—
06023803
—
MI
01
—
800185
FEDERAL BLACK LUNG PROGRA
—
05
—
804824
—
AZ
05
—
93272839
—
CO
05
—
G1735
—
NM
01
—
RB48
BC'BS OF NM PROVIDER #
NM
05
—
XMTA05996
—
CA
Enumeration date
08/18/2006
Last updated
08/03/2018
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