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General NPI Number Information
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NPI Number | 1457633687
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Entity Type | Organization
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Legal Business Name | TCCT LLC
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 90 B ROGER COMBS BLVD
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City | HINDMAN
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State | KY
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Zip | 41822
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Country | US
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Telephone | 606-785-5700
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Fax | 606-785-4004
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Provider Business Mailing Address
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Address Line | PO BOX 973
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City | HINDMAN
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State | KY
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Zip | 41822-0973
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Country | US
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Telephone | 606-785-5607
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Fax | 606-785-4004
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Authorized Official
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Title or Position | MEMBER
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Name | CHRISTOPHER TODD HALL
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Credential | PHARMD.
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Telephone | 606-785-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P07462
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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