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General NPI Number Information
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NPI Number | 1205772647
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Entity Type | Individual
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Provider Name | MRS. TRALANDAR TATE
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Gender | Female
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 132 MORNING VISTA DR
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City | MADISON
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State | AL
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Zip | 35758-8010
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Country | US
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Telephone | 719-465-9621
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Fax | 719-465-9621
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Provider Business Mailing Address
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Address Line | 132 MORNING VISTA DR
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City | MADISON
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State | AL
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Zip | 35758-8010
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Country | US
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Telephone | 719-465-9621
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Fax | 719-465-9621
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 9467778
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License Number State | AL
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