CCC Management, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CCC MANAGEMENT, LLC

Doing business as

Gillum Drug

Practice address

1237 Carter Ave
Ashland, KY 41101

Phone

(606) 393-5588

NPI assigned

Apr 10, 2019

Last updated

Apr 16, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Dawn Gillum

Title

Owner Manager

Phone

(606) 393-5588

Specialties & licenses 2

Addresses

Other names 1

• Gillum Drug Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Billy Joe McComas Jr., RPH

  • Pharmacist
  • Ashland, KY
  • NPI 1477285716
  NPD

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586995200000",
    "number": "1306309067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 CARTER AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017514",
            "telephone_number": "606-393-5588",
            "fax_number": "606-393-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 CARTER AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "41101",
            "telephone_number": "606-393-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCC MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A",
        "authorized_official_last_name": "GILLUM",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "606-393-5588"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gillum Drug",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gillum Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Ann Cathers, LCSW
• Hannah Caudill
• Megan Sexton Caudill, RDN, CDCES
• Savanna Caudill
• Timothy James Caudill, APRN, FNP-C
• Center for Comprehensive Services, Inc (NeuroRestorative Kentucky)
• Center for Comprehensive Services, Inc (NeuroRestorative)
• David Chaltas
• David Chalupa, LCSW
• Khaleta Chambers, CSW

• Community/Retail Pharmacy in Ashland, KY
• Providers in Ashland, KY by specialty
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.