| Organization Name: | CORK MEDICAL LLC |
| NPI Number: | 1306213301 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DESMOND SOUTH (HUMAN RESOURCE / COMPLIANCE DIR.) |
| Mailing Address: | 10835 Millington Ct Blue Ash |
| State: | OH US |
| Postal Code: | 452424019 |
| Phone Number: | 3173614563 |
| Fax Number: | |
| NPI Enumeration Date: | 08/25/2015 |
| NPI Last Update Date: | 04/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | HMER-23135 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |