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NPI Code Detail

MEDICARE: COOPER MEDICAL SOLUTIONS, LLC

MEDICARE: COOPER MEDICAL SOLUTIONS, LLC
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1710401526
Entity Type Code : Organization
Provider Name (Legal Business Name) : COOPER MEDICAL SOLUTIONS, LLC
Provider Business Mailing Address
First Line : 5601 BRIDGE ST STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76112-2355
Country : US
Telephone Number : 817-586-4422
Fax Number :
Provider Business Practice Location Address
First Line : 5601 BRIDGE ST STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76112-2355
Country : US
Telephone Number : 817-586-4422
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : JOHNNY CHANDASACK
Credential :
Telephone Number : 817-586-4422
Provider Enumeration Date : 08/02/2017
Last Update Date : 07/21/2022

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Directions to “COOPER MEDICAL SOLUTIONS, LLC ” Practice Location

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