Healthcare Provider Details

I. General information

NPI: 1902617541
Provider Name (Legal Business Name): CORA HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 S CONGRESS AVE STE 103
PALM SPRINGS FL
33461-3065
US

IV. Provider business mailing address

PO BOX 150
LIMA OH
45802-0150
US

V. Phone/Fax

Practice location:
  • Phone: 561-968-7788
  • Fax: 561-968-9968
Mailing address:
  • Phone: 419-216-9913
  • Fax: 567-301-3703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDREA K BEACH
Title or Position: PAYER RELATIONS MANAGER
Credential:
Phone: 419-221-6710