Fairfield Hose Company

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

01173 Issued in PA

Legal business name

FAIRFIELD HOSE COMPANY

Practice address

4896 E Lake Rd
Erie, PA 16511-1415

Phone

(814) 898-0007

Fax

(814) 899-8128

NPI assigned

Jan 14, 2006

Organization subpart

No

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

Authorized official

Name

James Hawryliw

Title

President

Phone

(814) 881-6193

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1137196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1689653933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 PORTER AVE",
            "city": "SCOTTDALE",
            "state": "PA",
            "postal_code": "156831141",
            "telephone_number": "724-887-6822",
            "fax_number": "724-887-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4896 E LAKE RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165111415",
            "telephone_number": "814-898-0007",
            "fax_number": "814-899-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD HOSE COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-14",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "HAWRYLIW",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-881-6193"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "01173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011361100003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jude Onyeka Ezechukwu, MD
• Andrea Fadrigo
• Shelly Elizabeth Fagan, PHARM.D.
• Samuel Allen Fagenholz, MD
• Andromeda Fair, CRNP
• Beth Marie Fairfield, LPN
• Kaitlin Fairlamb
• Tannous K Fakhry, MD
• Thomas Falasca, DO
• Ansley Falcon

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.