MEDICARE: COFII CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PH02132	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2989436	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1548215593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COFII CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 9830
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-9830
Country	:	US
Telephone Number	:	877-540-4748
Fax Number	:	801-716-4872

Provider Business Practice Location Address
First Line	:	2202 W CHARLESTON BLVD
Second Line	:	STE 13
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2232
Country	:	US
Telephone Number	:	702-384-3784
Fax Number	:	702-384-3796

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROCKELL HANKIN
Credential	:	RPH
Telephone Number	:	310-556-4422

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	10/14/2010

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Directions to “COFII CORPORATION ” Practice Location

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