MEDICARE: MEDEVAC MEDICAL RESPONSE 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457386385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDEVAC MEDICAL RESPONSE INC

Provider Business Mailing Address
First Line	:	PO BOX 847199
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7199
Country	:	US
Telephone Number	:	800-913-9106
Fax Number	:

Provider Business Practice Location Address
First Line	:	2730 S JACKSON CIR
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64057-1955
Country	:	US
Telephone Number	:	816-836-1594
Fax Number	:	816-254-1320

Authorized Official
Title or Position	:	EVP, CHIEF FINANCIAL OFFICER
Name	:	BRIAN SCOTT TIERNEY
Credential	:
Telephone Number	:	833-703-2294

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	04/17/2026

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