Healthcare Provider Details

I. General information

NPI: 1073977484
Provider Name (Legal Business Name): AMERICAN MEDICAL RESPONSE MID-ATLANTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2016
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 WASHINGTON BLVD
ELKRIDGE MD
21075-5533
US

IV. Provider business mailing address

PO BOX 409880
ATLANTA GA
30384-9880
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-1101
  • Fax: 800-498-2527
Mailing address:
  • Phone: 303-495-1748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: EDWARD VAN HORNE
Title or Position: COO
Credential:
Phone: 303-495-1220