Provider Demographics
NPI:1619071941
Name:METRO AMBULANCE SERVICE RURAL INC
Entity Type:Organization
Organization Name:METRO AMBULANCE SERVICE RURAL INC
Other - Org Name:AMERICAN MEDICAL RESPONSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OF REVENUE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-703-2294
Mailing Address - Street 1:PO BOX 198408
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8408
Mailing Address - Country:US
Mailing Address - Phone:833-703-2294
Mailing Address - Fax:
Practice Address - Street 1:420 JOHN R JUNKIN DR
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-3826
Practice Address - Country:US
Practice Address - Phone:601-442-4259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
LALA0000D100168OtherSECTION 1011
LA1991988Medicaid
MS0550035Medicaid
MS590000058OtherMEDICARE PTAN
MS590008529OtherMEDICARE RR
MS234904000OtherUS DOL - FECA
39144OtherHEALTHSPRINGS OF AL
39144OtherHEALTHSPRINGS OF AL
=========AOtherBCBS MS
LALA0000D100168OtherSECTION 1011
39144OtherSENIOR 1ST HEALTHSPRINGS