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General NPI Number Information
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NPI Number | 1942900113
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Entity Type | Organization
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Legal Business Name | C&C EXPRESS URGENT CARE LLC
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Dates
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Enumeration Date | 03/07/2023
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 773 HIGHWAY 138 SW STE 1
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City | RIVERDALE
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State | GA
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Zip | 30296-1599
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Country | US
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Telephone | 240-491-6813
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Fax |
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Provider Business Mailing Address
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Address Line | 773 HIGHWAY 138 SW STE 1
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City | RIVERDALE
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State | GA
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Zip | 30296-1599
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Country | US
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Telephone | 240-491-6813
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | CATHERINE NKONGHO
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Credential | NP
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Telephone | 240-491-6813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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