# COPPER STAR MEDICAL SUPPLY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COPPER STAR MEDICAL SUPPLY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376271627
- **Legal business name:** COPPER STAR MEDICAL SUPPLY
- **Authorized official:** SHERRY A MILDENBERGER RT (DIRECTOR OF CLINICAL SERVICES)
- **Authorized official phone:** (801) 590-2714

## Contact information

- **Practice address:** 2415 W ERIE DR, TEMPE, AZ 85282-3112
- **Practice address phone:** (623) 303-9548
- **Mailing address:** 132 E 13065 S STE 200, DRAPER, UT 84020-5646
- **Mailing address phone:** (801) 590-2714
- **Mailing address fax:** (801) 463-2880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | Yes |

## Other

- **Enumeration date:** 08/12/2022
- **Last updated:** 08/12/2022