Organization
EAGLE AIR MED CORPORATION
Active
Parent organization
EAGLE AIR MED CORPORATION
Other names
Eagle Air Med
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAGLE AIR MED CORPORATION
Authorized official
MR. ERIC THOMAS (SVP OF REVENUE MANAGEMENT)
(877) 728-8534
Entity
Organization
Contact information
Practice address
CHINLE MUNICIPAL AIRPORT, CHINLE, AZ 86503
(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
AIR
AZ
3416A0800X
Air Ambulance
Primary
—
AZ
3416L0300X
Land Ambulance
06-0007
AZ
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19929323
—
CO
05
—
387169
—
AZ
05
—
804717
—
AZ
05
—
R2833
—
NM
Enumeration date
08/10/2006
Last updated
09/26/2018
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