Provider Demographics
NPI:1427673565
Name:HC MEDICAL AND COSMETIC PRODUCTS LLC
Entity type:Organization
Organization Name:HC MEDICAL AND COSMETIC PRODUCTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRONDONA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:863-840-3125
Mailing Address - Street 1:125 US HIGHWAY 27 S
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-7918
Mailing Address - Country:US
Mailing Address - Phone:863-840-2826
Mailing Address - Fax:
Practice Address - Street 1:125 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:FL
Practice Address - Zip Code:33852-7918
Practice Address - Country:US
Practice Address - Phone:863-840-2826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies