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General NPI Number Information
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NPI Number | 1275514846
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Entity Type | Organization
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Legal Business Name | HANOVER VOLUNTEER FIRE DEPARTMENT BEAVER COUNTY
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 2697 ROUTE 18
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City | HOOKSTOWN
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State | PA
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Zip | 15050
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Country | US
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Telephone | 724-899-3144
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 726
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City | NEW CUMBERLAND
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State | PA
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Zip | 17070-0726
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Country | US
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Telephone | 717-214-6018
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Fax | 717-214-6020
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Authorized Official
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Title or Position | CHIEF
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Name | GARY TELLISH
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Credential |
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Telephone | 724-601-0220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 04006
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 06088
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License Number State | PA
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