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NPI Code Detail

MEDICARE: COCCO ENTERPRISES INC

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
1335E00000XProsthetic/Orthotic Supplier

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 : 1629070859
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 : 3575 QUAKERBRIDGE RD
Second Line : SUITE 204
City : TRENTON
State : NJ
Zip : 08619-1271
Country : US
Telephone Number : 609-393-5939
Fax Number : 609-393-5924
Authorized Official
Title or Position : DIRECTOR, CONTRACTING
Name : JANET WOODALL
Credential :
Telephone Number : 336-397-0993
Provider Enumeration Date : 06/01/2005
Last Update Date : 04/02/2020

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Directions to “COCCO ENTERPRISES INC ” Practice Location

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