MEDICARE: COOGAN CAREGIVERS LLC

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
1	251E00000X	Home Health Agency	R2424	MD

General Provider Information

NPI Number	:	1952437196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COOGAN CAREGIVERS LLC

Provider Business Mailing Address
First Line	:	10015 OLD COLUMBIA RD
Second Line	:	SUITE B215
City	:	COLUMBIA
State	:	MD
Zip	:	21046-1703
Country	:	US
Telephone Number	:	410-744-9175
Fax Number	:	443-276-6700

Provider Business Practice Location Address
First Line	:	5113 ILCHESTER WOODS WAY
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-6306
Country	:	US
Telephone Number	:	410-744-9175
Fax Number	:	443-276-6700

Authorized Official
Title or Position	:	PRESIDENT-CEO
Name	:	MRS. KATHRYN COOGAN PARKS
Credential	:	CSA
Telephone Number	:	410-744-9175

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	08/22/2020

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