Organization
CLIO RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD JOHNSON (CAPTAIN)
(334) 397-4402
Entity
Organization
Contact information
Practice address
3311 ELAMVILLE ST, CLIO, AL 36017-2706
(334) 397-4402
Mailing address
PO BOX 338, CLIO, AL 36017-0338
(334) 397-4402
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
180
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000051591
—
AL
01
—
510-51591
BLUE CROSS
AL
Enumeration date
10/18/2006
Last updated
05/02/2017
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