Provider Demographics
NPI:1922004092
Name:METRO AREA AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:METRO AREA AMBULANCE SERVICE, INC
Other - Org Name:METRO AREA AMBULANCE, METRO-AREA AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-255-0812
Mailing Address - Street 1:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-0595
Mailing Address - Country:US
Mailing Address - Phone:701-255-0812
Mailing Address - Fax:701-255-7247
Practice Address - Street 1:2940 N 19TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-5393
Practice Address - Country:US
Practice Address - Phone:701-255-0812
Practice Address - Fax:701-255-7247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND012341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI81330700Medicaid
WA9010703Medicaid
NDMET7430OtherBLUE CROSS NORTH DAKOTA
MT440479Medicaid
ND54918Medicaid
ID805369000Medicaid
SD9010320Medicaid
OH0706749Medicaid
MNA023827900Medicaid
WA9010703Medicaid
ND54918Medicaid