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General NPI Number Information
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NPI Number | 1568647402
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Entity Type | Organization
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Legal Business Name | C OPELAND HEALTH SERVICES, INC
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 417 RIDGE AVE N
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City | TIFTON
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State | GA
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Zip | 31794-4325
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Country | US
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Telephone | 229-256-4572
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Fax | 229-256-4573
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Provider Business Mailing Address
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Address Line | 417 RIDGE AVE N
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City | TIFTON
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State | GA
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Zip | 31794-4325
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Country | US
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Telephone | 229-256-4572
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Fax | 229-256-4573
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. JESSICA ROBIN COPELAND
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Credential |
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Telephone | 229-256-4572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 137-R-0006
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License Number State | GA
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