MEDICARE: AARON 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	051302918	IL
2	183500000X	Pharmacist	2019038197	MO

General Provider Information

NPI Number	:	1770189334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON COOPER PHARM.D.

Provider Business Mailing Address
First Line	:	3740 W TRUMAN BLVD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-0537
Country	:	US
Telephone Number	:	573-893-1044
Fax Number	:	573-893-1041

Provider Business Practice Location Address
First Line	:	3740 W TRUMAN BLVD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-0537
Country	:	US
Telephone Number	:	573-893-1044
Fax Number	:	573-893-1041

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

Provider Enumeration Date	:	12/09/2020
Last Update Date	:	07/27/2021

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Directions to “ AARON COOPER PHARM.D.” Practice Location

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