Provider Demographics
NPI:1720183544
Name:AMERICAN MEDICAL RESPONSE MID-ATLANTIC INC
Entity Type:Organization
Organization Name:AMERICAN MEDICAL RESPONSE MID-ATLANTIC INC
Other - Org Name:AMERICAN MEDICAL RESPONSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-495-1229
Mailing Address - Street 1:PO BOX 409880
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-9880
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6495 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3245
Practice Address - Country:US
Practice Address - Phone:301-270-9111
Practice Address - Fax:301-270-6911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD121341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD492155Medicare PIN