# COPE MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053822189
- **Authorized official:** MR. MARIO JOHNSON X MS, MST, MPH (CEO/OWNER)
- **Authorized official phone:** (225) 772-4677

## Contact information

- **Practice address:** 4242 HIGHWAY 19 STE B-3, ZACHARY, LA 70791-3982
- **Practice address phone:** (225) 772-4677
- **Mailing address:** 4242 HIGHWAY 19 STE B-3, ZACHARY, LA 70791-3982

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/16/2017
- **Last updated:** 06/16/2018