Provider Demographics
NPI:1497708887
Name:WILLIAM WALKER HOSE COMPANY
Entity type:Organization
Organization Name:WILLIAM WALKER HOSE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:YANOCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-876-1671
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:JERMYN
Mailing Address - State:PA
Mailing Address - Zip Code:18433-0013
Mailing Address - Country:US
Mailing Address - Phone:570-876-1671
Mailing Address - Fax:570-876-5167
Practice Address - Street 1:803 PENN AVE
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:PA
Practice Address - Zip Code:18433-1910
Practice Address - Country:US
Practice Address - Phone:570-876-1671
Practice Address - Fax:570-876-5167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA042123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA998520OtherBLUE CROSS NORTHEAST PA
PA080046300OtherFEDERAL BLACK LUNG
PA441590698OtherRAILROAD MEDICARE
PA073804OtherFIRST PRIORITY HEALTH
PA0012293090001Medicaid
PA74265OtherUNISON MEDICAID HMO
PA30755OtherGEISINGER HEALTH PLAN
PA281291Medicare ID - Type Unspecified