Cc Visions
Health Maintenance Organization in Mcdonough, GA. Organization (NPI-2).
NPI number1073814505
StatusActive
Last updated in NPPESJan 2, 2015
Details
- NPI
- 1073814505
- Entity type
- Organization (NPI-2)
- Legal business name
- Cc Visions
- Organization subpart
- No
- Enumeration date
- Nov 15, 2010
- Last updated
- Jan 2, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302R00000X | Health Maintenance Organization | 812199 | GA | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | 12053036 | GA |
Other names
- Celethia Coleman (Doing Business As)
Practice location
600 Addison WayMcdonough, GA 30253-8075
Phone 404-823-4481 · Fax 678-782-3530
Mailing address
600 Addison WayMcdonough, GA 30253-8075
Phone 404-823-4481 · Fax 678-782-3530
Authorized official
Celethia J Coleman
Cna/Pct
4048234481
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