MEDICARE: DR. VERNON FITZGERALD COOPER PHARM.D.

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	0202010364	VA

General Provider Information

NPI Number	:	1134340441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VERNON FITZGERALD COOPER PHARM.D.

Provider Business Mailing Address
First Line	:	3422 OLD CAPITOL TRL STE 1207
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19808-6124
Country	:	US
Telephone Number	:	800-206-1519
Fax Number	:

Provider Business Practice Location Address
First Line	:	3422 OLD CAPITOL TRL STE 1207
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19808-6124
Country	:	US
Telephone Number	:	800-206-1519
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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