Provider Demographics
NPI:1811208309
Name:RURAL RAPID RESPONSE INC
Entity type:Organization
Organization Name:RURAL RAPID RESPONSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:BRANTLEY
Authorized Official - Last Name:BLALOCK
Authorized Official - Suffix:
Authorized Official - Credentials:EMT PARAMEDIC
Authorized Official - Phone:601-431-0057
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39653-0577
Mailing Address - Country:US
Mailing Address - Phone:601-384-4002
Mailing Address - Fax:601-384-4001
Practice Address - Street 1:165 WALNUT ST. SOUTH
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:MS
Practice Address - Zip Code:39653
Practice Address - Country:US
Practice Address - Phone:601-384-4002
Practice Address - Fax:601-384-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS302G591919Medicare PIN