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General NPI Number Information
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NPI Number | 1124161583
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Entity Type | Organization
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Legal Business Name | WESLEYVILLE HOSE COMPANY NO 1
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | 3421 BUFFALO RD
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City | ERIE
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State | PA
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Zip | 16510-1813
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Country | US
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Telephone | 814-899-6704
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Fax | 814-899-4814
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Provider Business Mailing Address
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Address Line | 3421 BUFFALO RD
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City | ERIE
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State | PA
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Zip | 16510-1813
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Country | US
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Telephone | 814-899-6704
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Fax | 814-899-4814
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Authorized Official
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Title or Position | LIEUTENIENT
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Name | MR. SHAWN GARVER
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Credential |
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Telephone | 814-899-6704
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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 | 04281
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License Number State | PA
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