Provider Demographics
NPI:1992779094
Name:WATTSBURG HOSE CO
Entity type:Organization
Organization Name:WATTSBURG HOSE CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHMITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-739-9411
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:WATTSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16442-0186
Mailing Address - Country:US
Mailing Address - Phone:814-739-9411
Mailing Address - Fax:814-739-2929
Practice Address - Street 1:14415 MAIN ST
Practice Address - Street 2:
Practice Address - City:WATTSBURG
Practice Address - State:PA
Practice Address - Zip Code:16442-0186
Practice Address - Country:US
Practice Address - Phone:814-739-9411
Practice Address - Fax:814-739-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA033813416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA284312OtherBLUE CROSS/BLUE SHIELD
PA0007005000002Medicaid
PA344806OtherHEALTH ASSURANCE/AMER.
PA284312OtherBLUE CROSS/BLUE SHIELD
PA0007005000002Medicaid