Organization
THE CRESCENT HOSE COMPANY
Active
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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