Provider Demographics
NPI:1578931309
Name:COORDINATION CENTRIC LLC
Entity Type:Organization
Organization Name:COORDINATION CENTRIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:STONEBRAKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-340-4391
Mailing Address - Street 1:929 E ESPERANZA AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1483
Mailing Address - Country:US
Mailing Address - Phone:956-578-1732
Mailing Address - Fax:
Practice Address - Street 1:929 E ESPERANZA AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-1483
Practice Address - Country:US
Practice Address - Phone:956-578-1732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies