Provider Demographics
NPI:1639103864
Name:AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE INC
Other - Org Name:AMERICAN MEDCIAL RESPONSE (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 847925
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7925
Mailing Address - Country:US
Mailing Address - Phone:800-913-9106
Mailing Address - Fax:
Practice Address - Street 1:4377 SEYMOUR HWY
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76309-2701
Practice Address - Country:US
Practice Address - Phone:940-322-1506
Practice Address - Fax:940-322-1542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100820510BMedicaid
TX186717801Medicaid
TX186717802Medicaid
TXTX0000D100256OtherSECTION 1011
TXTX0000D100256OtherSECTION 1011