Provider Demographics
NPI:1427129139
Name:BOWMAN HEALTH CENTER
Entity type:Organization
Organization Name:BOWMAN HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PITCHFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-274-5216
Mailing Address - Street 1:83 S MARVIN ST
Mailing Address - Street 2:
Mailing Address - City:SMETHPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16749-2031
Mailing Address - Country:US
Mailing Address - Phone:814-887-5395
Mailing Address - Fax:
Practice Address - Street 1:83 S MARVIN ST
Practice Address - Street 2:
Practice Address - City:SMETHPORT
Practice Address - State:PA
Practice Address - Zip Code:16749-2031
Practice Address - Country:US
Practice Address - Phone:814-887-5395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHARLES COLE MEMORIAL HOSPTIAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-13
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1427206291OtherHIGHMARK BCBS
PA100001127-0013Medicaid
393416Medicare PIN
1427206291OtherHIGHMARK BCBS