Healthcare Provider Details

I. General information

NPI: 1417982034
Provider Name (Legal Business Name): COTTONWOOD AMBULANCE AND RESCUE SQUAD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 GRANGER ST
COTTONWOOD AL
36320
US

IV. Provider business mailing address

57 GRANGER ST
COTTONWOOD AL
36320
US

V. Phone/Fax

Practice location:
  • Phone: 334-691-5059
  • Fax:
Mailing address:
  • Phone: 334-691-5059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number190
License Number StateAL

VIII. Authorized Official

Name: THERESA STRENGTH
Title or Position: CAPTAIN
Credential:
Phone: 334-691-5059