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General NPI Number Information
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NPI Number | 1982633277
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Entity Type | Organization
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Legal Business Name | C & C PHARMACY INC.
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 621 W MEMORIAL DR
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City | DALLAS
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State | GA
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Zip | 30132-4120
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Country | US
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Telephone | 770-445-2600
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Fax | 770-445-1626
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Provider Business Mailing Address
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Address Line | 621 W MEMORIAL DR
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City | DALLAS
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State | GA
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Zip | 30132-4120
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Country | US
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Telephone | 770-445-2600
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Fax | 770-445-1626
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KIMBERLY B CURL
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Credential |
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Telephone | 770-445-2600
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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 | PHRE005178
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License Number State | GA
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