Provider Demographics
NPI:1780058271
Name:C&C MEDICAL EQUIPMENT & SUPPLIES, LLC
Entity type:Organization
Organization Name:C&C MEDICAL EQUIPMENT & SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-724-0480
Mailing Address - Street 1:PO BOX 146
Mailing Address - Street 2:
Mailing Address - City:MILLERS TAVERN
Mailing Address - State:VA
Mailing Address - Zip Code:23115-0146
Mailing Address - Country:US
Mailing Address - Phone:804-724-0480
Mailing Address - Fax:
Practice Address - Street 1:2382 KNIGHTS RUN RD
Practice Address - Street 2:
Practice Address - City:HEATHSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22473-3801
Practice Address - Country:US
Practice Address - Phone:804-724-0480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies