Provider Demographics
NPI:1659082139
Name:COOPER CONSULTANT GROUP LLC
Entity Type:Organization
Organization Name:COOPER CONSULTANT GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-614-9522
Mailing Address - Street 1:1419 MCMILLIAN RD
Mailing Address - Street 2:
Mailing Address - City:GREELEYVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29056
Mailing Address - Country:US
Mailing Address - Phone:704-614-9522
Mailing Address - Fax:
Practice Address - Street 1:1419 MCMILLIAN RD
Practice Address - Street 2:
Practice Address - City:GREELEYVILLE
Practice Address - State:SC
Practice Address - Zip Code:29056
Practice Address - Country:US
Practice Address - Phone:704-614-9522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies