MEDICARE: MRS. JACQUELINE FRANCO CORONA RRT, ALM

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BX2000X	Oxygen Equipment & Supplies (DME)
3	253Z00000X	In Home Supportive Care Agency	AZ
4	227900000X	Registered Respiratory Therapist
5	2279H0200X	Home Health Registered Respiratory Therapist
6	311ZA0620X	Adult Care Home Facility	AZ

General Provider Information

NPI Number	:	1780401703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JACQUELINE FRANCO CORONA RRT, ALM

Provider Business Mailing Address
First Line	:	1826 E INTREPID AVE
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-6817
Country	:	US
Telephone Number	:	480-495-5458
Fax Number	:

Provider Business Practice Location Address
First Line	:	1826 E INTREPID AVE
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-6817
Country	:	US
Telephone Number	:	480-495-5458
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2024
Last Update Date	:	09/21/2024

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