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General NPI Number Information
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NPI Number | 1487594040
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Entity Type | Organization
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Legal Business Name | TAC MEDICAL LLC
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 04/05/2026
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Provider Practice Location Address
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Address Line | 12467 IONA SOUND DR
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City | BRISTOW
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State | VA
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Zip | 20136-3030
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Country | US
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Telephone | 571-220-1894
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Fax |
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Provider Business Mailing Address
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Address Line | 8667 RUBY RISE PL
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City | BRISTOW
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State | VA
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Zip | 20136-2301
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Country | US
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Telephone | 571-220-1894
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Fax |
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | JAMES GALLANT
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Credential |
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Telephone | 571-220-1894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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