1386648293 NPI number — LIFEFLIGHT EAGLE

Table of content: (NPI 1386648293)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386648293 NPI number — LIFEFLIGHT EAGLE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIFEFLIGHT EAGLE
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:
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:
1386648293
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/11/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7830 NW 100TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64153-2323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-283-9710
Provider Business Mailing Address Fax Number:
816-283-9730

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7830 NW 100TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64153-2323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-283-9710
Provider Business Practice Location Address Fax Number:
816-283-9730
Provider Enumeration Date:
06/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ZALAR
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT CEO
Authorized Official Telephone Number:
816-283-9710

Provider Taxonomy Codes

  • Taxonomy code: 3416A0800X , with the licence number:  095257 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 054560 . This is a "FAMILY HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 590013663 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100273460A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 23736011 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 912284200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 803768209 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 11339 . This is a "HEALTHCARE USA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 795752 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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