# COPPER STAR MEDICAL SUPPLY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609599802
- **Authorized official:** SHERRY A MILDENBERGER RT (DIRECTOR OF CLINICAL SERVICES/COMP)
- **Authorized official phone:** (801) 590-2714

## Contact information

- **Practice address:** 1155 S POWER RD STE 111, MESA, AZ 85206-3716
- **Practice address phone:** (602) 960-4393
- **Mailing address:** 1155 S POWER RD STE 111, MESA, AZ 85206-3716
- **Mailing address phone:** (602) 960-4393

## Taxonomy

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

## Other

- **Enumeration date:** 09/22/2022
- **Last updated:** 09/22/2022