Healthcare Provider Details

I. General information

NPI: 1376916072
Provider Name (Legal Business Name): SO.CAP USA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2015
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 MYRTLE AVE
MAHOPAC FALLS NY
10542
US

IV. Provider business mailing address

P O BOX 51
MAHOPAC FALLS NY
10542
US

V. Phone/Fax

Practice location:
  • Phone: 914-423-6545
  • Fax:
Mailing address:
  • Phone: 914-423-6545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: RONALD CARDILLO
Title or Position: PRESIDENT
Credential:
Phone: 914-517-8669