C & G Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

C & G MEDICAL SUPPLY LLC

Practice address

120 N Park Dr
Fayetteville, GA 30214-1645

Phone

(770) 892-1420

NPI assigned

Mar 27, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cynthia Coaxum

Title

Authorized Official

Phone

(770) 892-1420

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1245080530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N PARK DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141645",
            "telephone_number": "770-892-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N PARK DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141645",
            "telephone_number": "770-892-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C & G MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "COAXUM",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "770-892-1420"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen N Busby, PA-C
• Laura P Bush, P.A.
• Jacob Byrd, RRT
• Linda W. Byrd, NP
• Byron F Harper III MD PC
• C H Martin Company
• Denny Cabo, FNP
• Gina Lee Cabrera-Benson, M.A., CCC-SLP
• Debbra Holder Caddell, LMT
• McArthur Cadet, MD

• Durable Medical Equipment & Medical Supplies in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.