| Ccmh Pediatrics | |
|
1001 East Second Street Coudersport PA 16915 | |
| (814) 274-9300 | |
| Not Available |
| Full Name | Ccmh Pediatrics |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1001 East Second Street, Coudersport, Pennsylvania |
| Authorized Official Name and Position | Ed Pitchford (CEO) |
| Authorized Official Contact | 8142745216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccmh Pediatrics 1001 East Second Street Coudersport PA 16915 Ph: () - | Ccmh Pediatrics 1001 East Second Street Coudersport PA 16915 Ph: (814) 274-9300 |
| NPI Number | 1134377088 |
|---|---|
| Provider Enumeration Date | 09/04/2008 |
| Last Update Date | 09/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134377088 | NPI | - | NPPES |
| 1376403 | Other | PA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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