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NPI Code Detail

MEDICARE: COLE CARE, INC.

MEDICARE: COLE CARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BP3500XParenteral & Enteral Nutrition Supplies (DME)PA
2332BX2000XOxygen Equipment & Supplies (DME)PA
3335E00000XProsthetic/Orthotic SupplierPA
4332B00000XDurable Medical Equipment & Medical SuppliesPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164406401
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLE CARE, INC.
Provider Business Mailing Address
First Line : 1001 E 2ND ST
Second Line :
City : COUDERSPORT
State : PA
Zip : 16915-8161
Country : US
Telephone Number : 814-274-7250
Fax Number : 814-274-7427
Provider Business Practice Location Address
First Line : 1001 E 2ND ST
Second Line :
City : COUDERSPORT
State : PA
Zip : 16915-8161
Country : US
Telephone Number : 814-274-7250
Fax Number : 814-274-7427
Authorized Official
Title or Position : CFO
Name : ROGER C. YOST
Credential :
Telephone Number : 570-321-3175
Provider Enumeration Date : 11/30/2005
Last Update Date : 04/04/2024

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