Organization
CHARLES COLE MEMORIAL HOSPTIAL
Active
Other names
CCMH ORTHOPEDICS PA
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD PITCHFORD (CEO)
(814) 274-9300
Entity
Organization
Contact information
Practice address
1001 EAST SECOND STREET, COUDERSPORT, PA 16915
(814) 274-9300
Mailing address
1001 EAST SECOND STREET, COUDERSPORT, PA 16915
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1738917
PA BLUE SHIELD
PA
Enumeration date
04/17/2007
Last updated
05/10/2010
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