MEDICARE: DALE COUNTY RESCUE AND RECOVERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	198	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043231525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALE COUNTY RESCUE AND RECOVERY

Provider Business Mailing Address
First Line	:	PO BOX 145
Second Line	:
City	:	NEWTON
State	:	AL
Zip	:	36352-0145
Country	:	US
Telephone Number	:	334-299-0222
Fax Number	:	334-299-3174

Provider Business Practice Location Address
First Line	:	449 S COLLEGE ST
Second Line	:
City	:	NEWTON
State	:	AL
Zip	:	36352-4018
Country	:	US
Telephone Number	:	334-299-0222
Fax Number	:	334-299-3174

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JIMMY BLACKMON
Credential	:
Telephone Number	:	334-333-3826

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	11/20/2008

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Directions to “DALE COUNTY RESCUE AND RECOVERY ” Practice Location

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