Organization
1223 SOUTH 15TH STREET CORPORATION
Active
Other names
Cocco Brothers
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLO A. COCCO BCO (PRESIDENT)
(215) 334-3816
Entity
Organization
Contact information
Practice address
2745 W PASSYUNK AVE, PHILADELPHIA, PA 19145-4012
(215) 334-3816
(215) 334-1998
Mailing address
2745 W PASSYUNK AVE, PHILADELPHIA, PA 19145-4012
(215) 334-3816
(215) 334-1998
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
6000003764
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39000573532
—
PA
Enumeration date
05/20/2006
Last updated
08/22/2020
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