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NPI Code Detail

MEDICARE: CURTIS V. COOPER PRIMARY HEALTH CARE, INC

MEDICARE: CURTIS V. COOPER PRIMARY HEALTH CARE, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1316972599
Entity Type Code : Organization
Provider Name (Legal Business Name) : CURTIS V. COOPER PRIMARY HEALTH CARE, INC
Provider Business Mailing Address
First Line : 106 EAST BROAD STREET
Second Line :
City : SAVANNAH
State : GA
Zip : 31401-2917
Country : US
Telephone Number : 912-527-1000
Fax Number : 912-527-1153
Provider Business Practice Location Address
First Line : 2 ROBERTS STREET
Second Line :
City : SAVANNAH
State : GA
Zip : 31408-3524
Country : US
Telephone Number : 912-527-1100
Fax Number : 912-527-1153
Authorized Official
Title or Position : CHIEF ADMINISTRATIVE OFFICER
Name : EARLENE JOINER DANIELS
Credential :
Telephone Number : 912-527-1088
Provider Enumeration Date : 07/12/2006
Last Update Date : 01/27/2020

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