OrganizationActive
Centercore Medical LLC
NPI 1306161427 · Prosthetic/Orthotic Supplier · Herrin, IL
Provider details
- NPI number
- 1306161427
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Corene Mavigliano, Owner(618) 713-6286
Specialties & taxonomies
Suppliers
Practice location
720 S Park Ave
Herrin, IL 62948-3816
Phone: (618) 713-6286
Fax: (618) 985-4636
Approximate (ZIP-level) locationGet directions
Mailing address
704 Grace Ln
Carterville, IL 62918-1058
Registry dates
- Enumerated
- 2010-03-31
- Last updated
- 2010-03-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.