You need to have an ambulance license issued by your state and have certified emts to operate at a basic level, and paramedics to operate at an advanced level. You also will need a lot of money to get started, to buy equipment and supplies ambulances, insurance which is very costly, vehicle maintenance just to name a few. It is hard to keep operating a service which charges not to mention the expense of a free ambulance service. Most of the services make most of their revenue from making transfers, from nursing homes and back home from the hospitals etc.. To get started contact the agency in your state that regulates ems, each state is different some have a board of ems others are regulated by some other state agency, contact someone from a local ambulance service and they can tell you who to contact.
Good Luck :)
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