MEDICARE: HUGHESTOWN HOSE COMPANY NO 1

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	03229	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	:	1275585655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUGHESTOWN HOSE COMPANY NO 1

Provider Business Mailing Address
First Line	:	30 CENTER ST
Second Line	:
City	:	HUGHESTOWN
State	:	PA
Zip	:	18640-3013
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 CENTER ST
Second Line	:
City	:	HUGHESTOWN
State	:	PA
Zip	:	18640-3013
Country	:	US
Telephone Number	:	570-654-4188
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMIE MERLINO
Credential	:
Telephone Number	:	570-654-4188

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	07/28/2014

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