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Organization
KOPP DRUG 58TH ST. INC.
Active
Organization
KOPP DRUG 58TH ST. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM E BARNEST RPH (COO)
(814) 949-9512
Entity
Organization
Contact information
Practice address
5800 6TH AVE, ALTOONA, PA 16602-1113
(814) 949-3988
(814) 949-0906
Mailing address
PO BOX 1471, ALTOONA, PA 16603-1471
(814) 949-9512
(814) 949-9505
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PP-481119
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019059780002
—
PA
Enumeration date
08/02/2005
Last updated
02/11/2010
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