# CLIO RESCUE SQUAD INC

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

## Provider details

- **NPI number:** 1659452555
- **Authorized official:** RICHARD JOHNSON (CAPTAIN)
- **Authorized official phone:** (334) 397-4402

## Contact information

- **Practice address:** 3311 ELAMVILLE ST, CLIO, AL 36017-2706
- **Practice address phone:** (334) 397-4402
- **Mailing address:** PO BOX 338, CLIO, AL 36017-0338
- **Mailing address phone:** (334) 397-4402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 180 | AL | Yes |

## Other

- **Enumeration date:** 10/18/2006
- **Last updated:** 05/02/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000051591 | — | AL |
| 01 | — | 510-51591 | BLUE CROSS | AL |