1223 South 15TH Street Corporation

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

6000003764 Issued in PA

Legal business name

1223 SOUTH 15TH STREET CORPORATION

Doing business as

Cocco Brothers

Practice address

2745 W Passyunk Ave
Philadelphia, PA 19145-4012

Phone

(215) 334-3816

Fax

(215) 334-1998

NPI assigned

May 20, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Carlo A. Cocco, BCO

Title

President

Phone

(215) 334-3816

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cocco Brothers Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396799722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 W PASSYUNK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454012",
            "telephone_number": "215-334-3816",
            "fax_number": "215-334-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 W PASSYUNK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454012",
            "telephone_number": "215-334-3816",
            "fax_number": "215-334-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1223 SOUTH 15TH STREET CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COCCO",
        "authorized_official_first_name": "CARLO",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-334-3816",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BCO"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "PA",
            "license": "6000003764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39000573532",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cocco Brothers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Customized Equipment (DME) in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Customized Equipment (DME) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.