# SAMSON VOL. RESCUE SQUAD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Samson Rescue Squad
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386773091
- **Authorized official:** GARY WIGINTON EMR (CAPTIAN)
- **Authorized official phone:** (334) 898-2471

## Contact information

- **Practice address:** 9 S RIPLEY ST, SAMSON, AL 36477-1410
- **Practice address phone:** (334) 898-1153
- **Practice address fax:** (334) 898-1153
- **Mailing address:** P O BOX 22, SAMSON, AL 36477
- **Mailing address phone:** (334) 898-1183
- **Mailing address fax:** (334) 898-1153

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 471 | AL | Yes |

## Other

- **Enumeration date:** 03/06/2007
- **Last updated:** 02/19/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000050191 | — | AL |
| 05 | — | 200031101 | — | AL |