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General NPI Number Information
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NPI Number | 1982738332
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Entity Type | Organization
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Legal Business Name | HOOVERSVILLE RESCUE SQUAD, INC.
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 80 MAIN STREET
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City | HOOVERSVILLE
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State | PA
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Zip | 15936
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Country | US
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Telephone | 814-798-5109
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Fax | 814-798-5109
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Provider Business Mailing Address
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Address Line | PO BOX 213
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City | HOOVERSVILLE
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State | PA
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Zip | 15936-0213
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Country | US
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Telephone | 814-798-5109
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Fax | 814-798-5109
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL BOMBOY
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Credential | NREMT-P
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Telephone | 814-445-9628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 56005
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License Number State | PA
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