MEDICARE: AMERICAN MEDICAL RESPONSE MID-ATLANTIC, 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	:	1861818965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN MEDICAL RESPONSE MID-ATLANTIC, INC.

Provider Business Mailing Address
First Line	:	PO BOX 100296
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-0296
Country	:	US
Telephone Number	:	800-913-9106
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 INCUBATOR RD
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23661-1347
Country	:	US
Telephone Number	:	757-826-7828
Fax Number	:

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

Provider Enumeration Date	:	03/13/2014
Last Update Date	:	01/28/2025

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