| Name: | Florala Rescue Squad, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 13 Dec 1988 (36 years ago) |
| Entity Number: | 000-066-930 |
| Register Number: | 000066930 |
| County: | Covington |
| Place of Formation: | Covington County |
| Principal Address: | FLORALA, AL |
| Registered Office Street Address: | 612 EAST 4TH AVEFLORALA, AL 36442 |
| Registered Office Street Address ZIP Code: | 36442 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720130636 | 2007-01-18 | 2010-11-18 | PO BOX 133, FLORALA, AL, 364420133, US | 612 E 4TH AVENUE, FLORALA, AL, 364420000, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 334-858-2503 |
Authorized person
| Name | JAMES YORK |
| Role | OWNER |
| Phone | 3348582503 |
Taxonomy
| Taxonomy Code | 3416L0300X - Land Ambulance |
| License Number | 227 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000056297 |
| State | AL |
| Issuer | BLUE CROSS BLUE SHIELD AL |
| Number | 051056297 |
| State | AL |
| Issuer | MEDICAID |
| Number | 907928900 |
| State | FL |
| Name | Role |
|---|---|
| YORK, JAMES N | Incorporator |
| MITCHELL, LARMAR | Incorporator |
| BARRINEAU, CINDY | Incorporator |
| Name | Role |
|---|---|
| YORK, JAMES M | Agent |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
