Provider Demographics
NPI:1417021189
Name:FRIENDSHIP HOOK, LADDER, HOSE AND AMBULANCE
Entity type:Organization
Organization Name:FRIENDSHIP HOOK, LADDER, HOSE AND AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-948-6234
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-0417
Mailing Address - Country:US
Mailing Address - Phone:610-705-3979
Mailing Address - Fax:610-705-3955
Practice Address - Street 1:269 GREEN ST
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-2214
Practice Address - Country:US
Practice Address - Phone:610-948-6234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA982153416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001182795 0001OtherPROMISE PROVIDER
PA0355652000OtherBLUE CROSS
PA1182795Medicaid
PA0355652000OtherKEYSTONE EAST
PA001182795 0001OtherPROMISE PROVIDER