MEDICARE: COOPERATIVE HEALTH SOLUTIONS

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	183500000X	Pharmacist	41168	CA

General Provider Information

NPI Number	:	1689912834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COOPERATIVE HEALTH SOLUTIONS

Provider Business Mailing Address
First Line	:	6268 SPRING MOUNTAIN RD STE 105B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-8874
Country	:	US
Telephone Number	:	702-674-6180
Fax Number	:

Provider Business Practice Location Address
First Line	:	6268 SPRING MOUNTAIN RD STE 105B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-8874
Country	:	US
Telephone Number	:	702-674-6180
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHRIS NEE
Credential	:
Telephone Number	:	702-674-6180

Provider Enumeration Date	:	01/23/2013
Last Update Date	:	01/23/2013

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