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General NPI Number Information
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NPI Number | 1508981655
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Entity Type | Organization
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Legal Business Name | CCE MEDICAL & NURSING SUPPLIES
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3217 BARLBOROUGH WAY
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-3050
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Country | US
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Telephone | 757-672-4288
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Fax | 757-301-6348
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Provider Business Mailing Address
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Address Line | 4239 HOLLAND RD STE 784 PMB 669
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1941
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Country | US
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Telephone | 757-672-4288
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Fax | 757-301-6348
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. THERESA CARBAJAL MASHTARE
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Credential | LPN
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Telephone | 757-672-4288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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