1134114929 NPI number — MIDWEST CORPORATE AIR CARE LLC

Table of content: (NPI 1134114929)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134114929 NPI number — MIDWEST CORPORATE AIR CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDWEST CORPORATE AIR CARE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134114929
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 672
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWTON
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67114-0672
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-281-8722
Provider Business Mailing Address Fax Number:
316-281-8723

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
516 N OLIVER RD
Provider Second Line Business Practice Location Address:
HANGAR J
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67114-9403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-281-8700
Provider Business Practice Location Address Fax Number:
316-281-8719
Provider Enumeration Date:
09/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RATZLAFF
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
H
Authorized Official Title or Position:
DIRECTOR OF BILLING SERVICES
Authorized Official Telephone Number:
316-281-8722

Provider Taxonomy Codes

  • Taxonomy code: 3416A0800X , with the licence number:  1255 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X , with the licence number: 1255 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200016100A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100250094-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: XMTA06001 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100457300A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 152821715 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 81896 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0568378 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 12324833 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 159261001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 806092201 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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