Healthcare Provider Details

I. General information

NPI: 1336284983
Provider Name (Legal Business Name): CCS MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 08/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14255 49TH ST N SUITE 301
CLEARWATER FL
33762-2813
US

IV. Provider business mailing address

1505 LBJ FREEWAY SUITE 600
FARMERS BRANCH TX
75234-6074
US

V. Phone/Fax

Practice location:
  • Phone: 800-726-9811
  • Fax: 800-860-4326
Mailing address:
  • Phone: 972-628-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. MONICA S RAINES
Title or Position: DIRECTOR/SECRETARY
Credential:
Phone: 972-628-2100