Organization
CCC MEDICAL INC
Active
Other names
Woodward's Express Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HEYWARD WOODWARD R.PH. (PRESIDENT)
(770) 483-6811
Entity
Organization
Contact information
Practice address
2280 SALEM RD SE, SUITE 103, CONYERS, GA 30013-2003
(770) 483-6811
(770) 483-1776
Mailing address
2280 SALEM RD SE, SUITE 103, CONYERS, GA 30013-2003
(770) 483-6811
(770) 483-1776
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
005339
GA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00112516A
—
GA
05
—
00112516B
—
GA
01
—
1108338
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/03/2006
Last updated
03/07/2023
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