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Cooperative Healthcare Services Inc

Organization Active NPI Family Nurse Practitioner · Saint Marys, GA

NPI 1659709152 · NPPES record last updated Oct 17, 2013

Key facts

NPI
1659709152
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN191658 (GA)
Legal business name
COOPERATIVE HEALTHCARE SERVICES INC
Practice address
2040 Dan Proctor Dr
Suite 140
Saint Marys, GA 31558-3811
Phone
(912) 679-8000
NPI assigned
Oct 17, 2013
Organization subpart
Yes
Parent organization (as reported)
COOPERATIVE HEALTHCARE SERVICES INC

Authorized official

Name
Mrs. Judy Marshall
Title
Manager, Physician Practices
Phone
(912) 466-5520

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1040187Southeast Georgia Physician Associates
2040 Dan Proctor Drive Suite 140, Saint Marys, GA 31558		Certificate of waiverMay 2, 2027

National Provider Directory

Tax ID family
Cooperative Healthcare SVCS (2 organizations share this tax ID)
Part of
Cooperative Healthcare SVCS

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP		 363LF0000X RN191658 GA Yes

Addresses

Primary practice location

2040 Dan Proctor Dr
Suite 140
Saint Marys, GA 31558-3811

Mailing address

2040 Dan Proctor Dr
Suite 140
Saint Marys, GA 31558-3811
Phone (912) 679-8000

Other names

  • Southeast Georgia Physicians Associates Camden Pediatrics Doing business as

Other providers in Saint Marys, GA

All providers in Saint Marys, GA · Family Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.