Healthcare Provider Details

I. General information

NPI: 1235034315
Provider Name (Legal Business Name): CURTIS V. COOPER PRIMARY HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1589 GA HIGHWAY 119 S
SPRINGFIELD GA
31329-3004
US

IV. Provider business mailing address

106 E BROAD ST
SAVANNAH GA
31401-2917
US

V. Phone/Fax

Practice location:
  • Phone: 912-527-1000
  • Fax: 912-527-1126
Mailing address:
  • Phone: 912-527-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL

VIII. Authorized Official

Name: EARLENE JOINER DANIELS
Title or Position: CFO
Credential:
Phone: 912-527-1088