Chinchilla Hose Company of South Abington Township

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

35004 Issued in PA

Legal business name

CHINCHILLA HOSE COMPANY OF SOUTH ABINGTON TOWNSHIP

Practice address

113 Shady Lane Rd
South Abington Township, PA 18411-9020

Phone

(570) 586-5726

Fax

(570) 587-2008

NPI assigned

Mar 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark Dougherty

Title

President

Phone

(570) 586-5626

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heath Gary Goldstein, EMT-B

  • Basic Emergency Medical Technician
  • South Abington Township, PA
  • NPI 1710060306
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627948800000",
    "number": "1043344674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 SHADY LANE RD",
            "city": "SOUTH ABINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184119020",
            "telephone_number": "570-586-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 SHADY LANE RD",
            "city": "SOUTH ABINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184119020",
            "telephone_number": "570-586-5726",
            "fax_number": "570-587-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHINCHILLA HOSE COMPANY OF SOUTH ABINGTON TOWNSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-586-5626",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "35004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590009247",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012904890001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLUE CROSS",
            "identifier": "081105900",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Bronson, PTA
• Deborah Buck
• Desiree Lynn Carlin, COTA/L
• Lisa Marie Carson, RPH
• Mark R Chapman
• Mackenzie Cigarski-Sutton
• David Michael Clark, D.M.D
• Jessica Clark, MRP
• Natasha Jael Cline, FNP-C
• Amy Beth Cravath, DMD

• Land Ambulance in South Abington Township, PA
• Providers in South Abington Township, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.