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	341600000X	Ambulance	5122	NE

General Provider Information

NPI Number	:	1336315225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 847199
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7199
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9340 G CT
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68127-1229
Country	:	US
Telephone Number	:	402-331-2257
Fax Number	:	402-331-2259

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EDWARD VAN HORNE
Credential	:
Telephone Number	:	303-495-1220

Provider Enumeration Date	:	05/01/2008
Last Update Date	:	08/20/2013

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