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NPI Code Detail

MEDICARE: CORA HEALTH SERVICES, INC.

MEDICARE: CORA HEALTH SERVICES, 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
1261QR0400XRehabilitation Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356801104
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORA HEALTH SERVICES, INC.
Provider Business Mailing Address
First Line : PO BOX 150
Second Line :
City : LIMA
State : OH
Zip : 45802-0150
Country : US
Telephone Number : 419-221-6717
Fax Number : 419-222-0507
Provider Business Practice Location Address
First Line : 465 TOWN PLAZA AVE STE B
Second Line :
City : PONTE VEDRA BEACH
State : FL
Zip : 32081-5164
Country : US
Telephone Number : 42-223-7809
Fax Number : 904-306-5772
Authorized Official
Title or Position : EXEC VP
Name : STEVE KRZYMINSKI
Credential :
Telephone Number : 419-221-6717
Provider Enumeration Date : 03/20/2019
Last Update Date : 10/11/2023

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