Provider Demographics
NPI:1396762217
Name:AMERICUS HOSE CO
Entity type:Organization
Organization Name:AMERICUS HOSE CO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALEX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-286-8711
Mailing Address - Street 1:PO BOX 675
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-0675
Mailing Address - Country:US
Mailing Address - Phone:570-286-8711
Mailing Address - Fax:570-286-8712
Practice Address - Street 1:100 LINDEN ST
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-3020
Practice Address - Country:US
Practice Address - Phone:570-286-8711
Practice Address - Fax:570-286-8712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30493OtherHEALTH AMERICA
PA0007268290001Medicaid
PA0007268290001Medicaid
590645174Medicare PIN