Organization
CHARLES COLE MEMORIAL HOSPITAL
Active
Other names
CCMH GASTROENTEROLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD PITCHFORD (CEO)
(814) 274-9300
Entity
Organization
Contact information
Practice address
1001 E 2ND ST, COUDERSPORT, PA 16915
(814) 274-9024
Mailing address
1001 E 2ND ST, COUDERSPORT, PA 16915
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001649083
BLUE SHIELD
PA
Enumeration date
02/05/2008
Last updated
09/15/2008
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