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General NPI Number Information
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NPI Number | 1063799872
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Entity Type | Organization
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Legal Business Name | CC HEALTH LLC
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 1045A ANDREW DRIVE
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City | WEST CHESTER
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State | PA
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Zip | 19380-3401
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Country | US
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Telephone | 877-701-9007
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Fax | 610-701-9007
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Provider Business Mailing Address
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Address Line | 667 MADISON AVE 14TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10065-8029
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Country | US
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Telephone | 212-486-0040
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Fax | 212-319-3328
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. YOSBANI JOSEPH HERNANDEZ
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Credential |
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Telephone | 212-486-0040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 39D1006449
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License Number State | PA
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