# PLEASANT BAY AMBULANCE SERVICE

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

## Provider details

- **NPI number:** 1649355017
- **Authorized official:** ELZIE MALONE (OWNER)
- **Authorized official phone:** (256) 331-4819

## Contact information

- **Practice address:** 1301 JACKSON AVE N, RUSSELLVILLE, AL 35653-1634
- **Practice address phone:** (256) 331-4819
- **Practice address fax:** (256) 331-7491
- **Mailing address:** PO BOX 133, RED BAY, AL 35582-0133
- **Mailing address phone:** (256) 331-4819
- **Mailing address fax:** (256) 331-7491

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 728 | AL | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 51077449 | BC/BS OF ALABAMA | AL |