# TALLAPOOSA EMS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255303921
- **Authorized official:** MICHAEL BRANDON MONTGOMERY (ACCOUNT MANAGER)
- **Authorized official phone:** (562) 496-2755

## Contact information

- **Practice address:** 201 MARIARDEN RD, DADEVILLE, AL 36853-6244
- **Practice address phone:** (256) 825-9811
- **Practice address fax:** (877) 679-6524
- **Mailing address:** PO BOX 595, DADEVILLE, AL 36853-0595
- **Mailing address phone:** (256) 825-9811
- **Mailing address fax:** (256) 825-2838

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 895 | AL | Yes |

## Other

- **Enumeration date:** 02/06/2006
- **Last updated:** 07/23/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 051555020 | — | AL |