Healthcare Provider Details

I. General information

NPI: 1528621042
Provider Name (Legal Business Name): CC&D SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2019
Last Update Date: 02/16/2021
Certification Date: 02/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 SNAPFINGER WOODS DR STE 108
DECATUR GA
30035-4020
US

IV. Provider business mailing address

5040 SNAPFINGER WOODS DR STE 108
DECATUR GA
30035-4020
US

V. Phone/Fax

Practice location:
  • Phone: 470-709-2915
  • Fax:
Mailing address:
  • Phone: 470-709-2915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DARREN CARTER
Title or Position: OWNER
Credential:
Phone: 770-687-9321