CCC Medical Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CCC MEDICAL INC

Doing business as

Woodward's Express Care Pharmacy

Practice address

2280 Salem Rd SE
Suite 103
Conyers, GA 30013-2003

Phone

(770) 483-6811

Fax

(770) 483-1776

NPI assigned

Oct 3, 2006

Last updated

Mar 7, 2023By 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

Heyward Woodward, R.PH.

Title

President

Phone

(770) 483-6811

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Woodward's Express Care Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1912091323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 SALEM RD SE",
            "address_2": "SUITE 103",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132003",
            "telephone_number": "770-483-6811",
            "fax_number": "770-483-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 SALEM RD SE",
            "address_2": "SUITE 103",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132003",
            "telephone_number": "770-483-6811",
            "fax_number": "770-483-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCC MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "WOODWARD",
        "authorized_official_first_name": "HEYWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-483-6811",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "005339",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00112516B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00112516A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1108338",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodward's Express Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Conyers, GA
• Providers in Conyers, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.