MEDICARE: KAUP PHARMACY, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	54013006	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811079619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAUP PHARMACY, INC.

Provider Business Mailing Address
First Line	:	PO BOX 605
Second Line	:
City	:	FORT RECOVERY
State	:	OH
Zip	:	45846-0605
Country	:	US
Telephone Number	:	419-375-7007
Fax Number	:	419-375-9104

Provider Business Practice Location Address
First Line	:	1201 COMMERCE STREET
Second Line	:
City	:	FT. RECOVERY
State	:	OH
Zip	:	45846
Country	:	US
Telephone Number	:	419-375-7007
Fax Number	:	419-375-9104

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JASON C ANDREWS
Credential	:
Telephone Number	:	419-375-7007

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	09/04/2024

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