NPIMap

Organization Active NPI

Charles Cole Memorial Hospital

  • Ophthalmology Physician
  • Coudersport, PA
National Provider Identifier
1962850792
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CHARLES COLE MEMORIAL HOSPITAL
Practice address
1001 E 2ND St
Coudersport, PA 16915-8161
Phone
(814) 274-7910
NPI assigned
Jun 2, 2016
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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1001 E 2ND St
Coudersport, PA 16915-8161

Mailing address

1001 E 2ND St
Coudersport, PA 16915-8161
Phone (814) 274-7407

Other names 1

  • Cole Memorial Ophthalmology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310001269 PA Part B Supplier - Clinic/Group Practice 3779487475 Receives reassigned benefits from 122 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coudersport, PA; Wellsboro, PA; Bradford, PA

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1962850792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161",
            "telephone_number": "814-274-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161",
            "telephone_number": "814-274-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES COLE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-02",
        "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": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cole Memorial Ophthalmology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cole Memorial Ophthalmology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coudersport, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.