Cell towers receive, amplify and transmit. Cell towers have huge coverage radius, called a cell, and require a lot of power. Your cell phone only has to be powerful enough to communicate with the nearest cell tower. Tower coverage radiuses overlap for smooth signal handoff when traveling from one cell to another. Location, speed and directionality info are collected (among other things) constantly.
Cell towers tie into the main communications grid, and into the provider network, using fiber optic links. LOTS of them. The communications network itself is made up of server implementations called Master Switch Offices and Subordinate Switch Offices (I don’t think SSO is what they’re called but I can’t remember). The MSO is where the magic happens. Your call or text or whatever goes from phone to tower to MSO, and from there it gets routed either to another MSO or directly out to a tower to go back to another phone. The MSO is where the provider figures out where their phones are and how to most efficiently and economically communicate to/from those phones. As long as your phone is on, your provider knows exactly where you are at any given time (within n meters).
Cell tower service radius is based on terrain and how high the antennas are, in relation to the surrounding landscape.
Source: I worked as a Network Engineer for one of the biggest cell phone companies in the US.
Caveat: That was 20 years ago, so some of the concepts I touch on may be dated, but I believe this is all still applicable and current.
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