Jessup Hose Co 2

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

05117 Issued in PA

Legal business name

JESSUP HOSE CO 2

Practice address

333 Hill St
Jessup, PA 18434-1036

Phone

(570) 498-1141

NPI assigned

Dec 6, 2006

Last updated

Jun 4, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mike Faramelli

Title

Chief

Phone

(570) 489-1141

Specialties & licenses 1

Addresses

Other identifiers 2

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

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1477612364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1846",
            "city": "SHAVERTOWN",
            "state": "PA",
            "postal_code": "187080846",
            "telephone_number": "570-714-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 HILL ST",
            "city": "JESSUP",
            "state": "PA",
            "postal_code": "184341036",
            "telephone_number": "570-498-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSUP HOSE CO 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "FARAMELLI",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "570-489-1141"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "05117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011760450001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "800356",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Foat
• Megan Eileen Gallik, MT-BC
• Geisinger Clinic (PrimeMed Medical Grp Jessup in collaboration w/ Geisinger Clinic)
• Stephanie Giancini, LPC
• James C Loomis DPM
• Limitless Diagnostics LLC
• James C Loomis, DPM
• Marissa Marra
• Paul a. Tomcykoski DO PC
• Sandra Rayman

• Land Ambulance in Jessup, PA
• Providers in Jessup, PA by specialty
• Land Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.