Healthcare Provider Details

I. General information

NPI: 1790066470
Provider Name (Legal Business Name): COROZO HEALTH & PRESCRIPTION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2011
Last Update Date: 09/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 690 KM 3.2 BO SABANA HOYOS
VEGA ALTA PR
00692
US

IV. Provider business mailing address

HC 83 BOX 7485
VEGA ALTA PR
00692-9248
US

V. Phone/Fax

Practice location:
  • Phone: 787-807-1414
  • Fax:
Mailing address:
  • Phone: 787-807-1414
  • 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 Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: JUAN M MORALES
Title or Position: PRESIDENT
Credential:
Phone: 787-807-1414