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Organization

THE CRESCENT HOSE COMPANY

Active
Other names
North East Fire Dept Ambulance
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JACK DIORAZIO III (AMBULANCE ADMINISTRATOR)
(814) 725-1047
Entity
Organization

Contact information

Practice address
36 E MAIN ST, NORTH EAST, PA 16428-1341
(814) 725-1047
(814) 725-2603
Mailing address
PO BOX 89, NORTH EAST, PA 16428-0089
(814) 725-1047
(814) 725-2603

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103047504001
PA
01
219622
UPMC HEALTH PLAN
PA
01
286459
BLUE CROSS/BLUE SHIELD
PA
01
345104
HEALTH AMERICA
PA
01
590015490
PALMETTO GBA
PA
Enumeration date
02/13/2006
Last updated
08/11/2021
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