Organization
BEAVERTOWN RESCUE HOSE CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE L. THOMAS (EMS CAPTAIN)
(570) 658-7147
Entity
Organization
Contact information
Practice address
222 SASSAFRAS AVE., BEAVERTOWN, PA 17813-9796
(570) 658-7147
(570) 658-8217
Mailing address
P.O. BOX 265, BEAVERTOWN, PA 17813-0265
(570) 658-7147
(570) 658-8217
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00105.62610001
—
PA
05
—
001056261
—
PA
01
—
590000537
RAILROAD MEDICARE
—
Enumeration date
08/02/2005
Last updated
01/26/2016
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