Med Express was based in Vidalia/Ferriday, Louisiana, (at one point they had basically shut Acadian out of Concordia Parish) but had units stationed in Natchez, and made frequent runs to NRH, and used to go to what used to be "charity" hospital in Natchez. They still have an VHF repeater in Natchez as its a higher vantage point than the lower flatter Concordia Parish, though they now mainly use the LWIN. They were mainly a "private" ambulance agency and used for transfers in MS. They never had an contract at least in Adams County as an primary or backup EMS service. But they still had a big chunk of the Adams County cash cow. (They also used to be the main EMS agency for Jefferson County) Pafford was rarely in Natchez back in the day except for rare transfers, or the Air One flight from LA. Though now Pafford has expanded into a very large regional service for MS, AR, and LA, so it would not surprise me to see them start making more inroads in the South/Southwest MS areas. Of course Pafford has MSWIN, AWIN, and some LWIN access, with those also tied into the VHF system they have. Back in the day, AMR had City of Natchez, and Metro-Rural had Adams County. Then I think for a while AMR lost the bid and MR had both, but then AMR got Natchez back again. Now I am not sure who runs which.