# GANTT AREA VOLUNTEER RESCUE SQUAD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619282035
- **Authorized official:** GLENN BOUTWELL (CO-CAPTAIN)
- **Authorized official phone:** (334) 818-1181

## Contact information

- **Practice address:** 28905 COMMERCE ST., GANTT, AL 36038
- **Practice address phone:** (334) 388-0501
- **Practice address fax:** (334) 388-0501
- **Mailing address:** PO BOX 113, GANTT, AL 36038-0015
- **Mailing address phone:** (334) 388-0501
- **Mailing address fax:** (334) 388-0501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 239 | AL | Yes |

## Other

- **Enumeration date:** 08/10/2010
- **Last updated:** 08/10/2010