Organization
CHARLES COLE MEM HOME HEALTH HBP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ED PITCHFORD (CHIEF EXECUTIVE OFFICER)
(814) 274-5216
Entity
Organization
Contact information
Practice address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-9300
Mailing address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-9300
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100001127-0111
—
PA
Enumeration date
08/18/2009
Last updated
08/18/2009
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