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NPI Code Detail

MEDICARE: DR. LAURA R KOOP PHARMD

MEDICARE: DR. LAURA R KOOP PHARMD
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
11835G0303XGeriatric Pharmacist16186-040WI

General Provider Information

NPI Number : 1588963284
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA R KOOP PHARMD
Provider Business Mailing Address
First Line : 5185 S 9TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53221-3627
Country : US
Telephone Number : 800-762-1407
Fax Number :
Provider Business Practice Location Address
First Line : 5185 S 9TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53221-3627
Country : US
Telephone Number : 800-762-1407
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2011
Last Update Date : 03/21/2011

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Directions to “ DR. LAURA R KOOP PHARMD” Practice Location

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