Healthcare Provider Details

I. General information

NPI: 1538354352
Provider Name (Legal Business Name): COOPER & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2007
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 RALPH DAVID ABERNATHY BLVD SW STE 2
ATLANTA GA
30312-2482
US

IV. Provider business mailing address

448 RALPH DAVID ABERNATHY BLVD SW STE 2
ATLANTA GA
30312-2482
US

V. Phone/Fax

Practice location:
  • Phone: 404-522-0029
  • Fax: 404-522-0703
Mailing address:
  • Phone: 404-522-0029
  • Fax: 404-522-0703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number031-R-0030
License Number StateGA

VIII. Authorized Official

Name: MS. AZIZA COOPER
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 404-522-0029