Individual ProviderCameron GlagolaFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1205 Grampian Blvd Ste 3c, Williamsport, PA 17701-1970(570) 320-7800(570) 321-8723PECOS EnrollmentBased on the most recent information from CMS, provider Cameron Glagola is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1477046845Provider TypeIndividualFull NameGlagola, CameronCredentialDOGenderMaleSole ProprietorNoEnumeration Date6/11/2018Last Updated8/25/2021Contact InformationPractice LocationPractice Address1205 Grampian Blvd Ste 3c, Williamsport, PA 17701-1970Phone(570) 320-7800FaxUnlisted FaxMailing LocationMailing Address1201 Grampian Blvd, Williamsport, PA 17701-1900Phone(570) 321-8723FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseOS021413PennsylvaniaCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseOT018662Pennsylvania