# CHARLES COLE MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CCMH SLEEP CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578789772
- **Authorized official:** EDWARD PITCHFORD (CEO)
- **Authorized official phone:** (814) 274-9300

## Contact information

- **Practice address:** 1001 E 2ND ST, COUDERSPORT, PA 16915-8161
- **Practice address phone:** (814) 274-9300
- **Mailing address:** 1001 E 2ND ST, COUDERSPORT, PA 16915-8161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 05/11/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1874570 | PA BLUE SHIELD | PA |