Coster Care
Organization Active NPI Family Medicine Physician · Jasper, GA
NPI 1275799322 · NPPES record last updated Oct 6, 2008
Key facts
- NPI
- 1275799322
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 045754 (GA)
- Legal business name
- COSTER CARE
- Practice address
- 91 Sammy McGhee Blvd
Suite 101
Jasper, GA 30143-7703 - Phone
- (706) 253-6200
- Fax
- (706) 253-6276
- NPI assigned
- Jul 29, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Charles Leo Coster, DO
- Title
- Physician
- Phone
- (706) 253-6200
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Ball Ground Family Practicepc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 045754 | GA | Yes |
Addresses
Primary practice location
91 Sammy McGhee Blvd
Suite 101
Jasper, GA 30143-7703
Mailing address
91 Sammy McGhee Blvd
Suite 101
Jasper, GA 30143-7703
Phone (706) 253-6200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000797945A | Medicaid | GA | |
| 000797948A | Medicaid | GA |
Other names
- Ball Ground Family Practice,P.C.
Other providers in Jasper, GA
- Haley Cook
- Lynn Cooper
- Leslie G Cornelison
- Kristen Elizabeth Cornelius
- Wanda Denise Correia
- Charles Leo Coster
- Cplace Jasper SNF LLC
- Laura Craig
- Crescent Services LLC
- Crescent Services LLC
All providers in Jasper, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.