Provider Demographics
NPI:1225138183
Name:ANTHONY COOPER
Entity Type:Organization
Organization Name:ANTHONY COOPER
Other - Org Name:C & C HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-508-7000
Mailing Address - Street 1:2297 FM 547
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75442-6709
Mailing Address - Country:US
Mailing Address - Phone:866-508-7000
Mailing Address - Fax:866-508-7000
Practice Address - Street 1:2297 FM 547
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75442-6709
Practice Address - Country:US
Practice Address - Phone:866-508-7000
Practice Address - Fax:866-508-7000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0076412332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0103723-01Medicaid
TX1085900001Medicare ID - Type Unspecified