NPIMap

Organization Active NPI

Charles Cole Memorial Hospital

  • Rural Health Clinic/Center
  • Shinglehouse, PA
National Provider Identifier
1407928757
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 identifiers 1

IdentifierTypeStateIssuer
100001127-0132MedicaidPA

Other names 1

  • Shinglehouse Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080724000778 PA Part A Provider - Rural Health Clinic 3779487475 Practice locations: Shinglehouse, PA

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
CorporationNon-profit
Incorporated
Aug 4, 1910 in PA
Enrollment address
129 North Puritan Street
Shinglehouse, PA 16748
Related CCNs
391313

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0670704Shinglehouse Health Center129 N Puritan Street, Shinglehouse, PA 16748Certificate of waiverMar 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Behavioral Health Dept51 organizations share this tax ID, including this one

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.

View all 24

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.

NameRoleSinceShare
Michael Callahan Individual Corporate DirectorBoard Member Jun 1, 2007
Maribeth McLaughlin Individual Corporate DirectorBoard Member Mar 1, 2018
Patrick Larsen Individual Corporate DirectorBoard Member Oct 1, 2019
Josh Costa Individual Corporate DirectorBoard Member Jan 3, 2022
Carrie Ennis Individual Corporate DirectorBoard Member Mar 1, 2018
Ron Reynolds Individual Corporate OfficerPresident Oct 6, 2025
W-2 Managing EmployeeAd; Oct 6, 2025
Elizabeth Wallace Individual Corporate OfficerSecretary Jan 3, 2022
Melynda Budd Individual Corporate OfficerTreasurer Jan 3, 2022
Alana Huck Individual Corporate OfficerVice Chair Jan 3, 2022
Upmc Organization, Pittsburgh, PA Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 2018 100%
Mary Ann Rigas Individual Corporate DirectorBoard Member Oct 1, 2019
John Leete Individual Corporate OfficerChair 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.

View all 63

Practitioners & affiliated clinicians

Practitioners 67

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 67

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001127-0132",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shinglehouse Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shinglehouse, PA

Sources for this page

Verify at the official NPI Registry.