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NPI Code Detail

MEDICARE: CCC MEDICAL EQUIPMENT, INC.

MEDICARE: CCC MEDICAL EQUIPMENT, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies878TN

General Provider Information

NPI Number : 1497178693
Entity Type Code : Organization
Provider Name (Legal Business Name) : CCC MEDICAL EQUIPMENT, INC.
Provider Business Mailing Address
First Line : 115 VICKSBURG AVE
Second Line :
City : CAMDEN
State : TN
Zip : 38320-1613
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 136 S WILSON ST
Second Line :
City : DRESDEN
State : TN
Zip : 38225-1133
Country : US
Telephone Number : 731-584-7919
Fax Number : 731-584-7920
Authorized Official
Title or Position : PRES/OWNER
Name : MS. BRENDA C MONTGOMERY
Credential :
Telephone Number : 731-584-7919
Provider Enumeration Date : 01/24/2014
Last Update Date : 01/29/2014

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Directions to “CCC MEDICAL EQUIPMENT, INC. ” Practice Location

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