Provider Demographics
NPI:1194169680
Name:C&C HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:C&C HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANYANGWE
Authorized Official - Middle Name:
Authorized Official - Last Name:NKONGHONYOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-889-2397
Mailing Address - Street 1:8305 OFFICE PARK DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-6935
Mailing Address - Country:US
Mailing Address - Phone:404-889-2397
Mailing Address - Fax:
Practice Address - Street 1:8305 OFFICE PARK DR
Practice Address - Street 2:SUITE H
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-6935
Practice Address - Country:US
Practice Address - Phone:404-889-2397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048-R-1001251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care