MEDICARE: T.C.C. GROUP INCORPORATED

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
1	251J00000X	Nursing Care Agency	NP3746	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NP3746	OTHER	NC	FACILITY ID: 080641 NURSING POOL

General Provider Information

NPI Number	:	1558519587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	T.C.C. GROUP INCORPORATED

Provider Business Mailing Address
First Line	:	4601 SIX FORKS RD
Second Line	:	SUITE 500
City	:	RALEIGH
State	:	NC
Zip	:	27609-5287
Country	:	US
Telephone Number	:	919-510-8165
Fax Number	:	919-571-8805

Provider Business Practice Location Address
First Line	:	4601 SIX FORKS RD
Second Line	:	SUITE 500
City	:	RALEIGH
State	:	NC
Zip	:	27609-5287
Country	:	US
Telephone Number	:	919-510-8165
Fax Number	:	919-571-8805

Authorized Official
Title or Position	:	PESIDENT/CEO
Name	:	MR. EVERTON URIAH CHRISTIE
Credential	:
Telephone Number	:	919-510-8165

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	09/03/2008

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