Provider Demographics
NPI:1255303921
Name:TALLAPOOSA EMS, LLC
Entity Type:Organization
Organization Name:TALLAPOOSA EMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LANCE
Authorized Official - Last Name:BEVELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-825-9811
Mailing Address - Street 1:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:DADEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36853-0595
Mailing Address - Country:US
Mailing Address - Phone:256-825-9811
Mailing Address - Fax:256-825-2838
Practice Address - Street 1:201 MARIARDEN RD
Practice Address - Street 2:
Practice Address - City:DADEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36853-6244
Practice Address - Country:US
Practice Address - Phone:256-825-9811
Practice Address - Fax:256-825-2838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8953416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport