Healthcare Provider Details

I. General information

NPI: 1972539633
Provider Name (Legal Business Name): C&C HOMECARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 NEWTOWN RD SUITE 300
PLAINVIEW NY
11803-4314
US

IV. Provider business mailing address

125 NEWTOWN RD SUITE 300
PLAINVIEW NY
11803-4314
US

V. Phone/Fax

Practice location:
  • Phone: 516-349-8610
  • Fax: 516-349-8611
Mailing address:
  • Phone: 516-349-8610
  • Fax: 516-349-8611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01774363
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: MRS. STACEY GRANAT
Title or Position: EXECUTIVE DIRECTOR OF OPERATIONS
Credential:
Phone: 516-349-8610