Cc Medical Supply
Durable Medical Equipment & Medical Supplies in Redan, GA. Organization (NPI-2).
NPI number1366749335
StatusActive
Last updated in NPPESMar 10, 2011
Details
- NPI
- 1366749335
- Entity type
- Organization (NPI-2)
- Legal business name
- Cc Medical Supply
- Organization subpart
- No
- Enumeration date
- Feb 27, 2011
- Last updated
- Mar 10, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | Yes |
| 332BC3200X | Durable Medical Equipment & Medical Supplies, Customized Equipment | – | – | |
| 332BD1200X | Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies | – | – | |
| 332S00000X | Hearing Aid Equipment | – | – |
Practice location
111 BoxRedan, GA 30074-0111
Phone 770-482-7755
Mailing address
6266 Windy Ridge TrlLithonia, GA 30058-6625
Phone 678-913-6375
Authorized official
Sharian Battle
President
6789136375
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