Organization
CLAY COUNTY RESCUE SQUAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETE DWIGHT WARD (DIRECTOR)
(256) 396-0445
Entity
Organization
Contact information
Practice address
453 TAYLOR RD, LINEVILLE, AL 36266
(256) 396-0445
(256) 396-0446
Mailing address
PO BOX 428, ASHLAND, AL 36251-0428
(256) 396-0445
(256) 396-0446
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
176
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51026201
BCBS OF ALABAMA
AL
Enumeration date
11/17/2006
Last updated
08/02/2007
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