# CCC MEDICAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Woodward's Express Care Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912091323
- **Authorized official:** HEYWARD WOODWARD R.PH. (PRESIDENT)
- **Authorized official phone:** (770) 483-6811

## Contact information

- **Practice address:** 2280 SALEM RD SE, SUITE 103, CONYERS, GA 30013-2003
- **Practice address phone:** (770) 483-6811
- **Practice address fax:** (770) 483-1776
- **Mailing address:** 2280 SALEM RD SE, SUITE 103, CONYERS, GA 30013-2003
- **Mailing address phone:** (770) 483-6811
- **Mailing address fax:** (770) 483-1776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 005339 | GA | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 03/07/2023