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General NPI Number Information
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NPI Number | 1164518544
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Entity Type | Organization
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Legal Business Name | C & C MEDICAL EQUIPMENT & SUPPLY INC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 6043 NW 167TH ST SUITE A-16
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City | MIAMI GARDENS
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State | FL
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Zip | 33015-4326
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Country | US
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Telephone | 305-392-9967
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Fax | 305-392-9968
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Provider Business Mailing Address
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Address Line | 6043 NW 167TH ST SUITE A-16
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City | MIAMI GARDENS
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State | FL
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Zip | 33015-4326
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Country | US
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Telephone | 305-392-9967
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Fax | 305-392-9968
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Authorized Official
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Title or Position | PRESIDENT
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Name | NELIS BAHDER
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Credential |
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Telephone | 954-663-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 460
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 3204502
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 460
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License Number State | FL
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