Provider Demographics
NPI:1306834874
Name:C & S HEALTHCARE , INC.
Entity Type:Organization
Organization Name:C & S HEALTHCARE , INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DECHANE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-289-4088
Mailing Address - Street 1:5360 SNAPFINGER WOODS DR
Mailing Address - Street 2:SUITE 128
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-4046
Mailing Address - Country:US
Mailing Address - Phone:404-289-4088
Mailing Address - Fax:404-289-4039
Practice Address - Street 1:5360 SNAPFINGER WOODS DR
Practice Address - Street 2:SUITE 128
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-4046
Practice Address - Country:US
Practice Address - Phone:404-289-4088
Practice Address - Fax:404-289-4039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20015628522332B00000X
GAPHHH0000413336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA992258537AMedicaid
GA992258537AMedicaid