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NPI Code Detail

MEDICARE: COOK MANAGEMENT SERVICES INC

MEDICARE: COOK MANAGEMENT SERVICES 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
1314000000XSkilled Nursing Facility1-015-1678GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-015-1678OTHERGANURSING HOME PERMIT
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770597304
Entity Type Code : Organization
Provider Name (Legal Business Name) : COOK MANAGEMENT SERVICES INC
Provider Business Mailing Address
First Line : PO BOX 790
Second Line :
City : RICHMOND HILL
State : GA
Zip : 31324-0790
Country : US
Telephone Number : 912-756-6130
Fax Number : 912-756-6540
Provider Business Practice Location Address
First Line : 127 CARTER ST
Second Line :
City : RICHMOND HILL
State : GA
Zip : 31324-3753
Country : US
Telephone Number : 912-756-6131
Fax Number : 912-756-6540
Authorized Official
Title or Position : COO
Name : TERRY COOK
Credential :
Telephone Number : 404-641-1919
Provider Enumeration Date : 07/28/2006
Last Update Date : 02/04/2022

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