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General NPI Number Information
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NPI Number | 1659452555
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Entity Type | Organization
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Legal Business Name | CLIO RESCUE SQUAD INC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 05/02/2017
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Provider Practice Location Address
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Address Line | 3311 ELAMVILLE ST
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City | CLIO
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State | AL
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Zip | 36017-2706
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Country | US
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Telephone | 334-397-4402
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 338
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City | CLIO
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State | AL
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Zip | 36017-0338
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Country | US
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Telephone | 334-397-4402
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Fax |
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Authorized Official
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Title or Position | CAPTAIN
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Name | RICHARD JOHNSON
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Credential |
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Telephone | 334-397-4402
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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 | 180
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License Number State | AL
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