# CITY OF PRATTVILLE

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

## Provider details

- **NPI number:** 1477627024
- **Authorized official:** DAVID TUCKER (CHIEF)
- **Authorized official phone:** (334) 358-3238

## Contact information

- **Practice address:** 102 MAIN ST W, SUITE C, PRATTVILLE, AL 36067-3034
- **Practice address phone:** (334) 358-3670
- **Practice address fax:** (334) 358-0113
- **Mailing address:** 102 MAIN ST W, SUITE C, PRATTVILLE, AL 36067-3034
- **Mailing address phone:** (334) 358-3670
- **Mailing address fax:** (334) 358-0113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 348 | AL | Yes |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 09/11/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000050157 | — | AL |
| 01 | — | 0510-50157 | BLUE CROSS | AL |
| 01 | — | 590000128 | RAILROAD MEDICARE | AL |