MEDICARE: MEDICOR HEALTHCARE 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	332BX2000X	Oxygen Equipment & Supplies (DME)	0688174	NJ
2	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1538208731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICOR HEALTHCARE INC

Provider Business Mailing Address
First Line	:	P.O. BOX 27783
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07101-7783
Country	:	US
Telephone Number	:	732-462-7615
Fax Number	:

Provider Business Practice Location Address
First Line	:	3037 MCNAUGHTON DR STE A
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-1851
Country	:	US
Telephone Number	:	803-403-9018
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	JACK MARQUEZ
Credential	:
Telephone Number	:	803-403-9018

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	08/27/2020

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Directions to “MEDICOR HEALTHCARE INC ” Practice Location

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