| Name: | CCEMS, Incorporated |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 09 Sep 2003 (21 years ago) |
| Entity Number: | 000-558-726 |
| Register Number: | 000558726 |
| County: | Coffee |
| Place of Formation: | Coffee County |
| Principal Address: | ELBA, AL |
| Registered Office Street Address: | 515 N CLAXTON AVEELBA, AL 36323 |
| Registered Office Street Address ZIP Code: | 36323 |
Activities
AID/ASSIST INDIVIDUALS IN TIME OF DISTRESS/DISASTER/NEED
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003997891 | 2006-10-18 | 2022-05-19 | 200 BUFORD ST, ELBA, AL, 363231706, US | 200 BUFORD ST, ELBA, AL, 363231706, US | |||||||||||||||||||||||||||||
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| Phone | +1 334-347-0333 |
Authorized person
| Name | LAURIE CONLEY |
| Role | OFFICE MANAGER/BILLING CLERK |
| Phone | 3343470333 |
Taxonomy
| Taxonomy Code | 3416L0300X - Land Ambulance |
| License Number | 611 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 051554333 |
| State | AL |
| Issuer | BCBS AL |
| Number | 515-19604 |
| State | AL |
| Name | Role |
|---|---|
| CROSBY, ROBERT C | Agent |
| Name | Role |
|---|---|
| PIERCE, STEPHANIE D | Incorporator |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
