Provider Demographics
NPI:1770297632
Name:CCRS LLC
Entity type:Organization
Organization Name:CCRS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-885-4808
Mailing Address - Street 1:200 N CARRIER PKWY STE 205
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-5476
Mailing Address - Country:US
Mailing Address - Phone:860-885-4808
Mailing Address - Fax:
Practice Address - Street 1:200 N CARRIER PKWY STE 205
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5476
Practice Address - Country:US
Practice Address - Phone:860-885-4808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies