Healthcare Provider Details

I. General information

NPI: 1811079619
Provider Name (Legal Business Name): KAUP PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 COMMERCE STREET
FT. RECOVERY OH
45846
US

IV. Provider business mailing address

PO BOX 605
FORT RECOVERY OH
45846-0605
US

V. Phone/Fax

Practice location:
  • Phone: 419-375-7007
  • Fax: 419-375-9104
Mailing address:
  • Phone: 419-375-7007
  • Fax: 419-375-9104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number54013006
License Number StateOH

VIII. Authorized Official

Name: JASON C ANDREWS
Title or Position: PRESIDENT
Credential:
Phone: 419-375-7007