Provider Demographics
NPI:1649439548
Name:CC HEALTH LLC
Entity type:Organization
Organization Name:CC HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP SCIENCE AND TECHNOLOGY
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBINO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-486-0040
Mailing Address - Street 1:1045 ANDREW DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380
Mailing Address - Country:US
Mailing Address - Phone:610-701-9007
Mailing Address - Fax:610-701-9009
Practice Address - Street 1:1045 ANDREW DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380
Practice Address - Country:US
Practice Address - Phone:610-701-9007
Practice Address - Fax:610-701-9009
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIGNAL GENETICS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-05
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA028371291U00000X
PA028371A291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA149674Medicare PIN