NPIMap

Organization Active NPI

Elgin Beaverdam Hose Co

  • Land Ambulance
  • Elgin, PA
National Provider Identifier
1447238563
Registry record updated Sep 10, 2012
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Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
04053 Issued in PA
Legal business name
ELGIN BEAVERDAM HOSE CO
Practice address
17920 North Main St.
Box 51
Elgin, PA 16413-0051
Phone
(814) 664-4140
Fax
(814) 664-4140
NPI assigned
Jan 9, 2006
Last updated
Sep 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Authorized official

Name
Susanna Akam
Title
Treasurer
Phone
(814) 664-4140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 04053 PA Primary

Addresses

Primary practice location

17920 North Main St.
Box 51
Elgin, PA 16413-0051

Mailing address

PO Box 51
17920 North Mian St.
Elgin, PA 16413-0051
Phone (814) 664-4140

Other identifiers 2

IdentifierTypeStateIssuer
288273OtherPABLUE CROSS/BLUE SHIELD
0010429360003MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347235200000",
    "number": "1447238563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51",
            "address_2": "17920 NORTH MIAN ST.",
            "city": "ELGIN",
            "state": "PA",
            "postal_code": "164130051",
            "telephone_number": "814-664-4140",
            "fax_number": "814-664-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17920 NORTH MAIN ST.",
            "address_2": "BOX 51",
            "city": "ELGIN",
            "state": "PA",
            "postal_code": "164130051",
            "telephone_number": "814-664-4140",
            "fax_number": "814-664-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELGIN BEAVERDAM HOSE CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2012-09-10",
        "status": "A",
        "authorized_official_last_name": "AKAM",
        "authorized_official_first_name": "SUSANNA",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "814-664-4140"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "04053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "288273",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010429360003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.