Healthcare Provider Details

I. General information

NPI: 1598553133
Provider Name (Legal Business Name): KAUP PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 E 4TH ST STE B
MINSTER OH
45865-1311
US

IV. Provider business mailing address

PO BOX 605
FORT RECOVERY OH
45846-0605
US

V. Phone/Fax

Practice location:
  • Phone: 567-603-0600
  • Fax: 567-603-0700
Mailing address:
  • Phone: 419-375-2323
  • Fax: 419-375-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: THERESA DILLER
Title or Position: BUSINESS ADMIN
Credential:
Phone: 419-733-0117