Organization
PLEASANT BAY AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELZIE MALONE (OWNER)
(256) 331-4819
Entity
Organization
Contact information
Practice address
1301 JACKSON AVE N, RUSSELLVILLE, AL 35653-1634
(256) 331-4819
(256) 331-7491
Mailing address
PO BOX 133, RED BAY, AL 35582-0133
(256) 331-4819
(256) 331-7491
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
728
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51077449
BC/BS OF ALABAMA
AL
Enumeration date
10/26/2006
Last updated
08/22/2020
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