Provider Demographics
NPI:1841233970
Name:COOK MANAGEMENT SERVICES INC
Entity Type:Organization
Organization Name:COOK MANAGEMENT SERVICES INC
Other - Org Name:DUBLINAIR HEALTH & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TERRELL
Authorized Official - Middle Name:B
Authorized Official - Last Name:COOK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:229-868-7406
Mailing Address - Street 1:PO BOX 1243
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31040-1243
Mailing Address - Country:US
Mailing Address - Phone:478-272-7437
Mailing Address - Fax:478-272-2427
Practice Address - Street 1:300 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2800
Practice Address - Country:US
Practice Address - Phone:478-272-7437
Practice Address - Fax:478-272-2427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-087-1943314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000059947AMedicaid
51001012 001OtherBCBS
GA000059947AMedicaid