MEDICARE: CHICORA INDEPENDENT HOSE COMPANY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	06004	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215026935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICORA INDEPENDENT HOSE COMPANY

Provider Business Mailing Address
First Line	:	202 WEST SLIPPERY ROCK ST
Second Line	:
City	:	CHICORA
State	:	PA
Zip	:	16025-3214
Country	:	US
Telephone Number	:	724-445-2220
Fax Number	:	724-445-2167

Provider Business Practice Location Address
First Line	:	202 WEST SLIPPERY ROCK ST
Second Line	:
City	:	CHICORA
State	:	PA
Zip	:	16025-3214
Country	:	US
Telephone Number	:	724-445-2220
Fax Number	:	724-445-2167

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. MICHAEL TURNER
Credential	:
Telephone Number	:	724-445-2220

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	09/01/2015

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Directions to “CHICORA INDEPENDENT HOSE COMPANY ” Practice Location

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