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General NPI Number Information
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NPI Number | 1538208731
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Entity Type | Organization
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Legal Business Name | MEDICOR HEALTHCARE INC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 3037 MCNAUGHTON DR STE A
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City | COLUMBIA
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State | SC
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Zip | 29223-1851
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Country | US
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Telephone | 803-403-9018
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 27783
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City | FREEHOLD
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State | NJ
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Zip | 07101-7783
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Country | US
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Telephone | 732-462-7615
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JACK MARQUEZ
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Credential |
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Telephone | 803-403-9018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0688174
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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