Healthcare Provider Details

I. General information

NPI: 1104970367
Provider Name (Legal Business Name): MCKEAN HOSE COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5011 SCHOOL ST
MC KEAN PA
16426-1413
US

IV. Provider business mailing address

5011 SCHOOL ST PO BOX 241
MCKEAN PA
16426-0241
US

V. Phone/Fax

Practice location:
  • Phone: 814-476-7321
  • Fax: 814-476-0631
Mailing address:
  • Phone: 814-476-7321
  • Fax: 814-476-0631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number2502164
License Number StatePA

VIII. Authorized Official

Name: FRANK BARNES
Title or Position: CHIEF 400
Credential:
Phone: 814-476-7321