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General NPI Number Information
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NPI Number | 1700086972
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Entity Type | Organization
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Legal Business Name | EAST END ENERGY LLC
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 1149 FIRE TOWER RD
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City | CLEARFIELD
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State | PA
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Zip | 16830-3246
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Country | US
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Telephone | 814-765-1218
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Fax | 814-768-9410
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Provider Business Mailing Address
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Address Line | 1149 FIRE TOWER RD
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City | CLEARFIELD
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State | PA
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Zip | 16830-3246
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Country | US
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Telephone | 814-765-1218
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Fax | 814-768-9410
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Authorized Official
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Title or Position | OWNER
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Name | MR. HERBERT J WILSON
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Credential |
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Telephone | 814-765-1218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 1019351000001
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License Number State | PA
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