Individual ProviderGeorge Thomas CooperRegistered NurseNursing Service ProvidersPractice Address4212 N 16th St, Phoenix, AZ 85016-5319(602) 263-1200PECOS EnrollmentBased on the most recent information from CMS, provider George Thomas Cooper does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1356612121Provider TypeIndividualFull NameCooper, George ThomasTitleMr.CredentialRNGenderMaleSole ProprietorNoEnumeration Date1/25/2012Last Updated1/25/2012Contact InformationPractice LocationPractice Address4212 N 16th St, Phoenix, AZ 85016-5319Phone(602) 263-1200Fax(602) 200-5383Mailing LocationMailing AddressPO Box 31001-0698, Pasadena, CA 91110-0698Phone(602) 263-1200Fax(602) 200-5383Provider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicenseRN050434Arizona