EAGLE AIR MED CORPORATION (NPI# 1427069962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427069962 |
| Entity Type | Organization |
| Organization Name | EAGLE AIR MED CORPORATION |
| Other Organization Name | EAGLE AIR MED |
| Practice Address |
Chinle Municipal Airport Chinle AZ 86503 |
| Mailing Address |
10888 S 300 W South Jordan UT 84095-4043 |
| Practice Telephone | 8016194900 |
| Practice Fax Number | 8016198077 |
| Mailing Telephone | 8016194900 |
| Mailing Fax Number | 8016198077 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2018-09-26 |
| Authorized Official Name | MR. ERIC THOMAS (SVP OF REVENUE MANAGEMENT) |
| Authorized Official Telephone | 8777288534 |
| Is Organization Subpart | Y |
| Parent Organization Name | EAGLE AIR MED CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3416L0300X |
Ambulance Specialization: Land Transport |
06-0007 | AZ | Transportation Services |
| N | 3416L0300X |
Ambulance Specialization: Land Transport |
Transportation Services | ||
| N | 3416A0800X |
Ambulance Specialization: Air Transport |
AIR | AZ | Transportation Services |
| Y | 3416A0800X |
Ambulance Specialization: Air Transport |
AZ | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 387169 | 05 | |
| AZ | 804717 | 05 | |
| CO | 19929323 | 05 | |
| NM | R2833 | 05 |
| Other Name | Type Code |
|---|---|
| Eagle Air Med | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 212 W Freedom Way, Blanding, UT 845113248 | 8016194900 |
| Street Address |
CHINLE MUNICIPAL AIRPORT |
| City | CHINLE |
| State | AZ |
| Zip Code | 86503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164042461 | Jonathan Lam | Optometrist | Us 191 & Hospital Dr., Chinle, AZ 86503 | 2020-04-16 |
| 1154950004 | David Gibrael | Pharmacist | Us 191 Hospital Drive, Chinle, AZ 86503 | 2020-04-03 |
| 1366076739 | Calli Jo Swenson | Pharmacist | Us 191 & Hospital Drive, Chinle, AZ 86503 | 2020-02-25 |
| 1336770338 | Quan The Truong | Pharmacist | Us Hway 191 & Hospital Road, Po Drawer Ph, Chinle, AZ 86503 | 2020-01-29 |
| 1275172264 | Alexandra Guthart | Pharmacist | Us 191 and Hospital Dr, Chinle, AZ 86503 | 2019-12-23 |
| 1811530819 | Brian Spencer | Dentist | U.S. 191 and Hospital Drive, Chinle, AZ 86503 | 2019-10-22 |
| 1881249084 | Natasha Renee Bitsui | Community Health Worker | Navajo Rte 7 and 102-1, C012-118, Chinle, AZ 86503 | 2019-08-05 |
| 1871063628 | Zachary Holtkamp | Physical Therapist | Off Highway 191, Hospital Rd, Chinle, AZ 86503 | 2018-12-04 |
| 1841774296 | Tanieca Marie Downing | Dietitian, Registered | U.S. 191 & Hospital Drive, Chinle, AZ 86503 | 2018-09-21 |
| 1417430331 | Virginia Lois Woollens | Dietitian, Registered | Chinle Comprehensive Healthcare Facility, Us 191, Chinle, AZ 86503 | 2018-09-07 |
| Find all providers in zip 86503 | ||||
| Taxonomy Code | 3416A0800X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Air Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093232258 | Guardian Flight LLC | Ambulance | Cvs Space 31, Us 191, Chinle, AZ 86503 | 2017-08-28 |
| 1285151506 | Guardian Flight LLC | Ambulance | Cvs Space 32, Us 191, Chinle, AZ 86503 | 2017-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952966087 | Rocky Mountain Holdings, LLC | Ambulance | 2755 Silvercreek Road, Bullhead City, AZ 86442-7904 | 2019-05-03 |
| 1588123673 | Guardian Flight LLC | Ambulance | 905 W Airport Rd, Springerville, AZ 85938-5015 | 2019-03-18 |
| 1043779135 | Guardian Flight LLC | Ambulance | 4500 E Aviation Way, Safford, AZ 85546-9479 | 2019-03-18 |
| 1407314784 | Rocky Mountain Holdings, LLC | Ambulance | 5880 Flightline Dr, Kingman, AZ 86401-6842 | 2019-03-06 |
| 1730646852 | Rocky Mountain Holdings, LLC | Ambulance | 3535 S Fortuna Ave, Yuma, AZ 85365-4207 | 2019-02-25 |
| 1114490836 | Ponderosa Aviation, Inc | Ambulance | 4500 Aviation Way, Safford, AZ 85546 | 2019-01-04 |
| 1912486275 | Guardian Flight LLC | Ambulance | 3151 E Airport Loop Ste 1, Show Low, AZ 85901-9583 | 2018-08-08 |
| 1952808230 | Med-trans Corporation | Ambulance | 1215 N Ivy Loop Ste 2, Casa Grande, AZ 85122-5406 | 2018-04-12 |
| 1164949483 | Guardian Flight LLC | Ambulance | Kayenta Mobile Home Park Hwy 163 Space 288, Kayenta, AZ 86033 | 2017-08-28 |
| 1912424300 | Guardian Flight LLC | Ambulance | 141 W 40th St, Yuma, AZ 85365-9641 | 2017-08-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.