Active NPI
Charles Cole Memorial Hospital
- Rural Health Clinic/Center
- Shinglehouse, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- CHARLES COLE MEMORIAL HOSPITAL
- Practice address
- 128 N Puritan Street
Shinglehouse, PA 16748 - Phone
- (814) 260-9352
- NPI assigned
- Nov 14, 2006
- Last updated
- Sep 9, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel James Glunk
- Title
- Interim President
- Phone
- (570) 321-2284
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Primary |
Addresses
Primary practice location
128 N Puritan Street
Shinglehouse, PA 16748
Mailing address
PO Box 668
Shinglehouse, PA 16748-0668
Phone (814) 260-9352
Other names 1
- Shinglehouse Health Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080724000778 | PA | Part A Provider - Rural Health Clinic | 3779487475 | Practice locations: Shinglehouse, PA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1407928757. Details of each certification follow.
Rural health clinic certification: CCN 393984
- Legal name
- CHARLES COLE MEMORIAL HOSPITAL
- Doing business as
- SHINGLEHOUSE HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jul 6, 1995
- Last certification
- Apr 8, 2021
- Ownership / control type
- 2B
- Organization structure
- Corporation
- Incorporated
- Aug 4, 1910 in PA
- Enrollment address
- 129 North Puritan Street
Shinglehouse, PA 16748 - Related CCNs
- 391313
Related certifications (CCN) 2
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
- Ambulatory Surgical Clinic/Center
- Coudersport, PA
- NPI 1619008554
Parent provider
-
dba UPMC Cole
- Critical Access Hospital
- Coudersport, PA
- NPI 1326161662
Parent provider
Other NPIs with the same Medicare PAC ID 12
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Galeton Health Center
- Rural Health Clinic/Center
- Galeton, PA
- NPI 1003988502
3779487475
-
dba Eldred Health Center
- Rural Health Clinic/Center
- Eldred, PA
- NPI 1164594495
3779487475
-
dba Emporium Health Center
- Rural Health Clinic/Center
- Emporium, PA
- NPI 1275605750
3779487475
-
dba UPMC Cole
- Critical Access Hospital
- Coudersport, PA
- NPI 1326161662
3779487475
-
- Medicare Defined Swing Bed Hospital Unit
- Coudersport, PA
- NPI 1487616470
3779487475
-
dba Coudersport Family Medicine
- Rural Health Clinic/Center
- Coudersport, PA
- NPI 1578637989
3779487475
-
- Rural Health Clinic/Center
- Port Allegany, PA
- NPI 1760554265
3779487475
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D0670704 | Shinglehouse Health Center | Certificate of waiver | Mar 14, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- North Hills Family Prac
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Rural Health Clinic/Center
- Smethport, PA
- NPI 1427129139
-
- Physical Medicine & Rehabilitation Physician
- Coudersport, PA
- NPI 1427228055
-
- Family Medicine Physician
- Coudersport, PA
- NPI 1225205388
-
- Maternal & Fetal Medicine Physician
- Coudersport, PA
- NPI 1437381829
-
- Ambulatory Surgical Clinic/Center
- Coudersport, PA
- NPI 1619008554
-
- Urology Physician
- Coudersport, PA
- NPI 1154798163
-
dba Eldred Health Center
- Rural Health Clinic/Center
- Eldred, PA
- NPI 1164594495
-
- Family Medicine Physician
- Coudersport, PA
- NPI 1194985077
-
dba Emporium Health Center
- Rural Health Clinic/Center
- Emporium, PA
- NPI 1275605750
-
- Rural Health Clinic/Center
- Ulysses, PA
- NPI 1275605776
-
dba CCMH Oncology and Hematology
- Hematology & Oncology Physician
- Coudersport, PA
- NPI 1346460250
-
- Otolaryngology Physician
- Coudersport, PA
- NPI 1356794226
Ownership & related parties
All disclosed owners & managing parties 12
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Michael Callahan | Corporate Director | Jun 1, 2007 | |
| Maribeth McLaughlin | Corporate Director | Mar 1, 2018 | |
| Patrick Larsen | Corporate Director | Oct 1, 2019 | |
| Josh Costa | Corporate Director | Jan 3, 2022 | |
| Carrie Ennis | Corporate Director | Mar 1, 2018 | |
| Ron Reynolds | Corporate Officer | Oct 6, 2025 | |
| W-2 Managing Employee | Oct 6, 2025 | ||
| Elizabeth Wallace | Corporate Officer | Jan 3, 2022 | |
| Melynda Budd | Corporate Officer | Jan 3, 2022 | |
| Alana Huck | Corporate Officer | Jan 3, 2022 | |
| Upmc | 5% Or Greater Direct Ownership Interest | Mar 1, 2018 | 100% |
| Mary Ann Rigas | Corporate Director | Oct 1, 2019 | |
| John Leete | Corporate Officer | Jan 3, 2022 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Facilities with the same owner 63
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Galeton Health Center
- Rural Health Clinic/Center
- Galeton, PA
- NPI 1003988502
Upmc
-
dba Eldred Health Center
- Rural Health Clinic/Center
- Eldred, PA
- NPI 1164594495
Upmc
-
dba Emporium Health Center
- Rural Health Clinic/Center
- Emporium, PA
- NPI 1275605750
Upmc
-
dba UPMC Cole
- Critical Access Hospital
- Coudersport, PA
- NPI 1326161662
Upmc
-
- Medicare Defined Swing Bed Hospital Unit
- Coudersport, PA
- NPI 1487616470
Upmc
-
dba Coudersport Family Medicine
- Rural Health Clinic/Center
- Coudersport, PA
- NPI 1578637989
Upmc
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Williamsport, PA
- NPI 1881654010
-
- Urology Physician
- Coudersport, PA
- NPI 1356453062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757376000000",
"number": "1407928757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 668",
"city": "SHINGLEHOUSE",
"state": "PA",
"postal_code": "167480668",
"telephone_number": "814-260-9352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 N PURITAN STREET",
"city": "SHINGLEHOUSE",
"state": "PA",
"postal_code": "16748",
"telephone_number": "814-260-9352"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHARLES COLE MEMORIAL HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-14",
"last_updated": "2025-09-09",
"certification_date": "2025-09-09",
"status": "A",
"authorized_official_last_name": "GLUNK",
"authorized_official_first_name": "DANIEL",
"authorized_official_middle_name": "JAMES",
"authorized_official_title_or_position": "INTERIM PRESIDENT",
"authorized_official_telephone_number": "570-321-2284"
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Shinglehouse Health Center",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Shinglehouse, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.