Organization
COOPERS PHARMACY LLC
Active
Other names
Cooper's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK BERGGREN (OWNER)
(225) 975-5715
Entity
Organization
Contact information
Practice address
810 W HIGHWAY 30, GONZALES, LA 70737-4806
(225) 450-6299
Mailing address
41117 CLEARWATER AVE, GONZALES, LA 70737-0731
(225) 975-5715
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PENDING
LA
Other
Enumeration date
07/26/2018
Last updated
07/26/2018
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