Provider Demographics
NPI:1821098781
Name:BEACON HOSE COMPANY 1
Entity Type:Organization
Organization Name:BEACON HOSE COMPANY 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-729-1470
Mailing Address - Street 1:PO BOX 131
Mailing Address - Street 2:
Mailing Address - City:BEACON FALLS
Mailing Address - State:CT
Mailing Address - Zip Code:06403-1169
Mailing Address - Country:US
Mailing Address - Phone:203-729-2800
Mailing Address - Fax:203-729-2808
Practice Address - Street 1:35 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:BEACON FALLS
Practice Address - State:CT
Practice Address - Zip Code:06403-1169
Practice Address - Country:US
Practice Address - Phone:203-729-1470
Practice Address - Fax:203-723-2209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC006B1341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance