Provider Demographics
NPI:1619911971
Name:AMERICAN MEDICAL RESPONSE OF MASSACHUSETTS INC
Entity Type:Organization
Organization Name:AMERICAN MEDICAL RESPONSE OF MASSACHUSETTS INC
Other - Org Name:AMR
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 100330
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0330
Mailing Address - Country:US
Mailing Address - Phone:800-913-9106
Mailing Address - Fax:
Practice Address - Street 1:595 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3220
Practice Address - Country:US
Practice Address - Phone:413-846-6100
Practice Address - Fax:413-733-5230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3993341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008094147Medicaid
MA025959OtherBLUE CROSS
RI205131OtherBLUE CROSS
NH7101395Y0NH01OtherANTHEM
ME147550000Medicaid
702034OtherHARVARD PILGRIM
CT008091367Medicaid
ME020442OtherANTHEM
NH30009127Medicaid
MA1704591Medicaid
8035553OtherLIBERTY BY TUFTS
=========OtherFALLON
=========OtherPIONEER
MA1704591Medicaid
=========OtherHEALTH NEW ENGLAND
MA1704591Medicaid
ME147550000Medicaid
MEMM6145Medicare PIN