Organization
COOPER DRUG INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT KAPPELMANN (OWNER)
(316) 775-2289
Entity
Organization
Contact information
Practice address
509 STATE ST, AUGUSTA, KS 67010-1107
(316) 775-2289
(316) 775-2280
Mailing address
509 STATE ST, AUGUSTA, KS 67010-1107
(316) 775-2289
(316) 775-2280
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
202834
KS
3336C0003X
Community/Retail Pharmacy
Primary
PS005254
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004344000B
MEDICAID DME
KS
Enumeration date
10/02/2006
Last updated
10/29/2020
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