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
1	261QR0400X	Rehabilitation Clinic/Center		FL

Other Identifiers

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

General Provider Information

NPI Number	:	1982117446
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	:	9560 CROSSHILL BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32222-5850
Country	:	US
Telephone Number	:	904-573-0046
Fax Number	:	904-573-0772

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT
Name	:	STEPHEN KRZYMINSKI
Credential	:
Telephone Number	:	419-221-6717

Provider Enumeration Date	:	11/07/2017
Last Update Date	:	09/28/2023

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Directions to “CORA HEALTH SERVICES INC ” Practice Location

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