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General NPI Number Information
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NPI Number | 1588870992
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Entity Type | Organization
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Legal Business Name | GOODWILL HOSE COMPANY AMBULANCE ASSOCIATION
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 512 CANAL ST
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City | FLEMINGTON
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State | PA
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Zip | 17745-3714
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Country | US
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Telephone | 570-748-9022
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Fax | 570-748-0174
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Provider Business Mailing Address
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Address Line | PO BOX 18537
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City | PLEASANT HILLS
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State | PA
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Zip | 15236-0537
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Country | US
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Telephone | 800-521-0671
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Fax | 724-234-4703
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Authorized Official
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Title or Position | CHIEF OF OPERATIONS
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Name | KIM SHAINLINE
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Credential |
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Telephone | 570-748-9022
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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 | 033166
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License Number State | PA
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