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General NPI Number Information
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NPI Number | 1669700845
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Entity Type | Organization
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Legal Business Name | COOPER DRUG INC
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Dates
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Enumeration Date | 11/25/2009
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 511 STATE ST
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City | AUGUSTA
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State | KS
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Zip | 67010
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Country | US
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Telephone | 316-775-2289
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Fax | 316-775-2280
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Provider Business Mailing Address
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Address Line | 511 STATE ST
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City | AUGUSTA
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State | KS
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Zip | 67010-1107
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Country | US
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Telephone | 316-775-2289
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Fax | 316-775-2280
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Authorized Official
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Title or Position | OWNER
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Name | BRETT KAPPELMANN
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Credential |
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Telephone | 316-775-2289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 2-10266
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License Number State | KS
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