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General NPI Number Information
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NPI Number | 1508876467
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Entity Type | Organization
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Legal Business Name | ENTERPRISE RESCUE INC.
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/27/2007
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Provider Practice Location Address
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Address Line | 519 E LEE ST
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City | ENTERPRISE
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State | AL
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Zip | 36330-2284
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Country | US
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Telephone | 334-347-0333
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Fax | 334-347-7666
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Provider Business Mailing Address
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Address Line | PO BOX 311190
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City | ENTERPRISE
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State | AL
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Zip | 36331-1190
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Country | US
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Telephone | 334-347-0333
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Fax | 334-347-7666
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Authorized Official
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Title or Position | TREASURE
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Name | MR. AVON BOSARGE
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Credential | EMT-II
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Telephone | 334-347-0333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 219
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License Number State | AL
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