Organization
CORRY MEDICAL SERVICES, INC.
Active
Parent organization
CORRY MEDICAL SERVICES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORRY MEDICAL SERVICES, INC.
Authorized official
MR. MICHAEL HELLER (CFO)
(814) 664-4641
Entity
Organization
Contact information
Practice address
300 YORK ST, CORRY, PA 16407-1420
(814) 665-8288
(814) 664-8618
Mailing address
PO BOX 76642, CLEVELAND, OH 44101-6500
(330) 759-9119
(330) 759-3330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007733850023
—
PA
01
—
CG9021
RAILROAD MEDICARE
PA
Enumeration date
10/26/2006
Last updated
10/19/2007
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