Paul M Derderian Do
LBN: Community Cancer Care Specialists
Paul M Derderian Do is an health care organization with primary practice located at 1030 Harrington St Ste 301, Mount Clemens MI 48043-2967. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Non-Pharmacy Dispensing Site, Suppliers / Community/Retail Pharmacy. Suppliers / Non-Pharmacy Dispensing Site is the primary health care specialty.
Community Cancer Care Specialists can be contacted via phone (586) 493-3440, or through Nowak, Leslie via phone (586) 493-3435.
Contact Information
Primary practice address
1030 Harrington St Ste 301
Mount Clemens MI 48043-2967
Phone: (586) 493-3440
Fax: (586) 493-3455
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Non-Pharmacy Dispensing Site | 332900000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 5101009575 | Michigan |
Profile Details
| NPI number | 1407962442 |
|---|---|
| LBN Legal business name | Community Cancer Care Specialists |
| DBA Doing business as | Paul M Derderian Do |
| Authorized official | Nowak, Leslie |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 22nd, 2006 |
| Last updated | Aug 22nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407962442 | NPPES |
| Other | 2368430 | OTHER ID NUMBER-COMMERCIAL NUMBER |
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