MEDICARE: C&T CONCIERGE CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1023548724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C&T CONCIERGE CARE, LLC

Provider Business Mailing Address
First Line	:	2610 REAGAN AVE APT 101
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3214
Country	:	US
Telephone Number	:	757-470-9613
Fax Number	:

Provider Business Practice Location Address
First Line	:	2610 REAGAN AVE APT 101
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3214
Country	:	US
Telephone Number	:	757-470-9613
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CICELY R WRENN
Credential	:
Telephone Number	:	757-470-9613

Provider Enumeration Date	:	06/14/2017
Last Update Date	:	07/21/2022

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