Healthcare Provider Details

I. General information

NPI: 1265549562
Provider Name (Legal Business Name): ASHFORD AMBULANCE AND RESCUE SQUAD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 MIDLAND ST
ASHFORD AL
36312
US

IV. Provider business mailing address

PO BOX 368
ASHFORD AL
36312-0368
US

V. Phone/Fax

Practice location:
  • Phone: 334-899-5115
  • Fax: 334-899-1341
Mailing address:
  • Phone: 334-899-5115
  • Fax: 334-899-1341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number123
License Number StateAL

VIII. Authorized Official

Name: MS. JANICE ELLEN BLIZZARD
Title or Position: SECRETARY/TREASURER
Credential: NREMT-P
Phone: 334-899-5115