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NPI Code Detail

MEDICARE: C & C MEDICAL GROUP, INC.

MEDICARE: C & C MEDICAL GROUP, 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
1261Q00000XClinic/Center
2261QH0100XHealth Service Clinic/Center
3208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1871649525
Entity Type Code : Organization
Provider Name (Legal Business Name) : C & C MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : 6513 BURR ST
Second Line :
City : EAST RIDGE
State : TN
Zip : 37412-4201
Country : US
Telephone Number : 706-861-2700
Fax Number : 706-861-2745
Provider Business Practice Location Address
First Line : 1384 BATTLEFIELD PKWY
Second Line :
City : FORT OGLETHORPE
State : GA
Zip : 30742-4010
Country : US
Telephone Number : 706-861-2700
Fax Number : 706-861-2745
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MRS. CONNIE N. COUCH
Credential :
Telephone Number : 706-861-2700
Provider Enumeration Date : 01/26/2007
Last Update Date : 11/02/2023

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Directions to “C & C MEDICAL GROUP, INC. ” Practice Location

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