MEDICARE: STANCLIFF 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	02258	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	:	1427037779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STANCLIFF HOSE COMPANY

Provider Business Mailing Address
First Line	:	409 PORTER AVE
Second Line	:
City	:	SCOTTDALE
State	:	PA
Zip	:	15683-1141
Country	:	US
Telephone Number	:	724-887-6822
Fax Number	:	724-887-9440

Provider Business Practice Location Address
First Line	:	328 HIGH ST
Second Line	:
City	:	WATERFORD
State	:	PA
Zip	:	16441-8310
Country	:	US
Telephone Number	:	814-796-2181
Fax Number	:	814-796-6790

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	RON JAGTA
Credential	:
Telephone Number	:	814-796-2181

Provider Enumeration Date	:	01/14/2006
Last Update Date	:	12/06/2022

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Directions to “STANCLIFF HOSE COMPANY ” Practice Location

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