Provider Demographics
NPI:1083776686
Name:RURAL-METRO MID-SOUTH LP
Entity Type:Organization
Organization Name:RURAL-METRO MID-SOUTH LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-227-6078
Mailing Address - Street 1:PO BOX 731048
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-1048
Mailing Address - Country:US
Mailing Address - Phone:800-889-1581
Mailing Address - Fax:317-781-6198
Practice Address - Street 1:414 N 5TH ST
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-5126
Practice Address - Country:US
Practice Address - Phone:573-686-1000
Practice Address - Fax:573-686-6877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO023086341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO806328407Medicaid
MO806328407Medicaid