MEDICARE: COCCO ENTERPRISES INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1265573364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COCCO ENTERPRISES INC

Provider Business Mailing Address
First Line	:	2534 EMPIRE DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-6710
Country	:	US
Telephone Number	:	336-397-2165
Fax Number	:	336-397-2167

Provider Business Practice Location Address
First Line	:	1255 WHITEHORSE MERCERVILLE RD
Second Line	:	SUITE 503
City	:	HAMILTON
State	:	NJ
Zip	:	08619-3800
Country	:	US
Telephone Number	:	609-581-5250
Fax Number	:	609-581-5258

Authorized Official
Title or Position	:	DIRECTOR OF CONTRACTING
Name	:	SARAH YOUNG
Credential	:
Telephone Number	:	336-397-0991

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	10/18/2017

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Directions to “COCCO ENTERPRISES INC ” Practice Location

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