Provider Demographics
NPI:1477813541
Name:CORIUM INC
Entity Type:Organization
Organization Name:CORIUM INC
Other - Org Name:CORIUM GROUP INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-237-7727
Mailing Address - Street 1:4410 W 16TH AVE
Mailing Address - Street 2:SUITE 62
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4410 W 16TH AVE
Practice Address - Street 2:SUITE 62
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7100
Practice Address - Country:US
Practice Address - Phone:786-237-7727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty