Provider Demographics
NPI:1447295704
Name:THOMPSON HOSE CO
Entity type:Organization
Organization Name:THOMPSON HOSE CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CONKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-727-2431
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-0535
Mailing Address - Country:US
Mailing Address - Phone:315-635-1789
Mailing Address - Fax:315-635-3289
Practice Address - Street 1:53 WATER ST
Practice Address - Street 2:
Practice Address - City:THOMPSON
Practice Address - State:PA
Practice Address - Zip Code:18465
Practice Address - Country:US
Practice Address - Phone:717-727-2431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA04172341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
590009311OtherRAILROAD MEDICARE
PA0014535840002Medicaid
1453584OtherUPMC
590009311OtherRAILROAD MEDICARE