MEDICARE: AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance
2	341600000X	Ambulance

General Provider Information

NPI Number	:	1770518490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE INC

Provider Business Mailing Address
First Line	:	PO BOX 749667
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90074-9667
Country	:	US
Telephone Number	:	800-913-9106
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 N WASHINGTON ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-2437
Country	:	US
Telephone Number	:	509-323-8825
Fax Number	:

Authorized Official
Title or Position	:	CHIEF ADMINISTRATIVE OFFICER
Name	:	TIMOTHY JOSEPH DORN
Credential	:
Telephone Number	:	833-703-2294

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/11/2024

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