Healthcare Provider Details
I. General information
NPI: 1376508515
Provider Name (Legal Business Name): THE FRIENDSHIP HOSE COMPANY NO 1 OF NEWVILLE PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/19/2006
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 EAST BIG SPRING ROAD
NEWVILLE PA
17241
US
IV. Provider business mailing address
4 W MAIN ST PO BOX 3539
SHIREMANSTOWN PA
17011-6326
US
V. Phone/Fax
- Phone: 717-776-4747
- Fax: 717-776-9321
- Phone: 717-920-8460
- Fax: 717-901-5731
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | |
| License Number State | PA |
VIII. Authorized Official
Name:
TROY
LEE
WISER
Title or Position: PRESIDENT
Credential:
Phone: 717-776-4747