Provider Demographics
NPI:1578843892
Name:J CORONA INVESTMENTS LLC
Entity Type:Organization
Organization Name:J CORONA INVESTMENTS LLC
Other - Org Name:GREAT AMERICAN SCOOTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:E
Authorized Official - Last Name:CORONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-251-8888
Mailing Address - Street 1:1004 E BLUE BELL RD
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-2417
Mailing Address - Country:US
Mailing Address - Phone:979-251-8888
Mailing Address - Fax:
Practice Address - Street 1:1004 E BLUE BELL RD
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-2417
Practice Address - Country:US
Practice Address - Phone:832-545-5379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6621800001Medicare NSC