Healthcare Provider Details

I. General information

NPI: 1922911221
Provider Name (Legal Business Name): MR. ALVIN M. COOPER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 WOLFTRAP CT
NEWPORT NEWS VA
23605-1819
US

IV. Provider business mailing address

1309 WOLFTRAP CT
NEWPORT NEWS VA
23605-1819
US

V. Phone/Fax

Practice location:
  • Phone: 757-234-1149
  • Fax: 855-975-2982
Mailing address:
  • Phone: 757-234-1149
  • Fax: 855-975-2982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: