Provider Demographics
NPI:1336284983
Name:CCS MEDICAL, INC.
Entity Type:Organization
Organization Name:CCS MEDICAL, INC.
Other - Org Name:CCS MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-628-2100
Mailing Address - Street 1:1505 LBJ FREEWAY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-6074
Mailing Address - Country:US
Mailing Address - Phone:972-628-2100
Mailing Address - Fax:
Practice Address - Street 1:14255 49TH ST N
Practice Address - Street 2:SUITE 301
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-2813
Practice Address - Country:US
Practice Address - Phone:800-726-9811
Practice Address - Fax:800-860-4326
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CCS MEDICAL HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-21
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies