Organization
AIR EVAC EMS INC.
Active
Organization
AIR EVAC EMS INC.
Active
Other names
INTERCARE MEDICAL TRANSPORT INC
Organization subpart
No
Provider details
NPI number
Authorized official
C GREG WITTENBRINK (VP OF FINANCE)
(417) 256-0010
Entity
Organization
Contact information
Practice address
322 SW 25TH AVE, MINERAL WELLS, TX 76067-8244
(940) 327-8702
(940) 327-8915
Mailing address
PO BOX 106, WEST PLAINS, MO 65775-0106
(417) 256-0010
(417) 257-5761
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
182008
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00101800
RAILROAD MEDICARE
—
Enumeration date
12/29/2005
Last updated
08/22/2020
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