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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
13336C0002XClinic PharmacyPHRE005935GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376756023
Entity Type Code : Organization
Provider Name (Legal Business Name) : CURTIS V. COOPER PRIMARY HEALTH CARE, INC.
Provider Business Mailing Address
First Line : 106 E BROAD ST
Second Line :
City : SAVANNAH
State : GA
Zip : 31401-2917
Country : US
Telephone Number : 912-527-1000
Fax Number :
Provider Business Practice Location Address
First Line : 2 ROBERTS ST
Second Line :
City : SAVANNAH
State : GA
Zip : 31408-3524
Country : US
Telephone Number : 912-527-1000
Fax Number :
Authorized Official
Title or Position : CHIEF ADMINISTRAIVE OFFICER
Name : EARLENE JOINER DANIELS
Credential :
Telephone Number : 912-527-1088
Provider Enumeration Date : 05/08/2007
Last Update Date : 01/27/2020

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