| Name: | Cottonwood Ambulance and Rescue Squad, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 28 Nov 1989 (35 years ago) |
| Entity Number: | 000-067-804 |
| Register Number: | 000067804 |
| ZIP code: | 36320 |
| County: | Houston |
| Place of Formation: | Houston County |
| Principal Address: | COTTONWOOD, AL |
| Registered Office Street Address: | 106 S METCALF STREETCOTTONWOOD, AL 36320 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417982034 | 2006-07-12 | 2020-08-22 | 57 GRANGER ST, COTTONWOOD, AL, 36320, US | 57 GRANGER ST, COTTONWOOD, AL, 36320, US | |||||||||||||||||||||||
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| Phone | +1 334-691-5059 |
Authorized person
| Name | THERESA STRENGTH |
| Role | CAPTAIN |
| Phone | 3346915059 |
Taxonomy
| Taxonomy Code | 3416L0300X - Land Ambulance |
| License Number | 190 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 510-56520 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| JOHNSON, LARRY | Agent | 103 N MAIN STCOFFEE SPRINGS, AL 36318 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, LARRY | Incorporator | 103 N MAIN STCOFFEE SPRINGS, AL 36318 |
| ELLIOTT, CAROLE | Incorporator | No data |
| BOLIN, CAROL | Incorporator | No data |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
