CCC Medical Equipment, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

00000000878 Issued in TN

Legal business name

CCC MEDICAL EQUIPMENT, INC.

Practice address

205 Hospital Dr
MC Kenzie, TN 38201-1649

Phone

(731) 352-6005

Fax

(731) 352-6006

NPI assigned

Nov 5, 2013

Last updated

Jul 31, 2014By 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

Mrs. Brenda C Montgomery

Title

President/Owner

Phone

(731) 584-7919

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1750710331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 VICKSBURG AVE",
            "city": "CAMDEN",
            "state": "TN",
            "postal_code": "383201613",
            "telephone_number": "731-584-7919",
            "fax_number": "731-584-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-6005",
            "fax_number": "731-352-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCC MEDICAL EQUIPMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "731-584-7919",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "00000000878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Spivey Burress, OD
• Cassie Denise Butler, PTA
• Kenneth T Butler, LAT, ATC
• Rustin Forest Cameron, PA-C
• Elijah Carpenter, FNP
• Briana Page Chandler, FNP-C
• Philemon D Chang, M.D.
• Alice Chapman, R.D. L.D.N.
• Christian Care Center of McKenzie LLC
• Terry Andrew Colotta, MD

• Durable Medical Equipment & Medical Supplies in McKenzie, TN
• Providers in McKenzie, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.