Provider Demographics
NPI:1386086536
Name:OMNIFLIGHT HELICOPTERS, INC.
Entity type:Organization
Organization Name:OMNIFLIGHT HELICOPTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APPLICATIONS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-915-2317
Mailing Address - Street 1:1620 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-4950
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1620 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4950
Practice Address - Country:US
Practice Address - Phone:909-915-2317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIR METHODS CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
U6942Medicare PIN