Provider Demographics
NPI:1497803571
Name:CORRY MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:CORRY MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-664-4641
Mailing Address - Street 1:PO BOX 76642
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44101-6500
Mailing Address - Country:US
Mailing Address - Phone:330-759-9119
Mailing Address - Fax:330-759-3330
Practice Address - Street 1:336 YORK ST
Practice Address - Street 2:
Practice Address - City:CORRY
Practice Address - State:PA
Practice Address - Zip Code:16407-1413
Practice Address - Country:US
Practice Address - Phone:814-664-4641
Practice Address - Fax:814-663-0105
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORRY MEDICAL SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-08
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty