Provider Demographics
NPI:1871209619
Name:C & C MEDICAL EQUIPMENT LLC
Entity type:Organization
Organization Name:C & C MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CONNER
Authorized Official - Middle Name:FOX
Authorized Official - Last Name:PAVONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-891-7608
Mailing Address - Street 1:318 CHIPPEWA ST
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-2096
Mailing Address - Country:US
Mailing Address - Phone:248-891-7608
Mailing Address - Fax:
Practice Address - Street 1:318 CHIPPEWA ST
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-2096
Practice Address - Country:US
Practice Address - Phone:248-891-7608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies