Organization
CCC MANAGEMENT, LLC
Active
Other names
Gillum Drug
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA DAWN GILLUM (OWNER MANAGER)
(606) 393-5588
Entity
Organization
Contact information
Practice address
1237 CARTER AVE, ASHLAND, KY 41101
(606) 393-5588
Mailing address
1237 CARTER AVE, ASHLAND, KY 41101-7514
(606) 393-5588
(606) 393-3947
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/10/2019
Last updated
04/16/2020
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