Organization
CURTIS V. COOPER PRIMARY HEALTH CARE,INC
Active
Other names
Westside Urban Health Center, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEON L. BURTON (EXECUTIVE DIRECTOR)
(912) 527-1000
Entity
Organization
Contact information
Practice address
840A HITCH DRIVE, SAVANNAH, GA 31401-3040
(912) 232-9696
(912) 527-1153
Mailing address
106 EAST BROAD STREET, SAVANNAH, GA 31401-2917
(912) 527-1000
(912) 527-1153
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000463922C
—
GA
01
—
10063424
AMERIGROUP
GA
01
—
336179
WELLCARE
GA
Enumeration date
07/25/2007
Last updated
11/24/2009
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