NPIMap

Organization Active NPI

Pleasant Bay Ambulance Service

  • Land Ambulance
  • Russellville, AL
National Provider Identifier
1649355017
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
728 Issued in AL
Legal business name
PLEASANT BAY AMBULANCE SERVICE
Practice address
1301 Jackson Ave N
Russellville, AL 35653-1634
Phone
(256) 331-4819
Fax
(256) 331-7491
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Elzie Malone
Title
Owner
Phone
(256) 331-4819

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 728 AL Primary

Addresses

Primary practice location

1301 Jackson Ave N
Russellville, AL 35653-1634

Mailing address

PO Box 133
Red Bay, AL 35582-0133
Phone (256) 331-4819

Other identifiers 1

IdentifierTypeStateIssuer
51077449OtherALBC/BS OF ALABAMA

National Provider Directory

National Provider Directory

Locations

1301 Jackson Ave N
Russellville, AL 35653
Phone (256) 331-4819

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649355017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 133",
            "city": "RED BAY",
            "state": "AL",
            "postal_code": "355820133",
            "telephone_number": "256-331-4819",
            "fax_number": "256-331-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 JACKSON AVE N",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356531634",
            "telephone_number": "256-331-4819",
            "fax_number": "256-331-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT BAY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "ELZIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-331-4819"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AL",
            "license": "728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF ALABAMA",
            "identifier": "51077449",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.