Individual
DR. KENNETH EDWARD COOPER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
4371 E LOHMAN AVE, LAS CRUCES, NM 88011-8255
(575) 532-8900
Mailing address
4371 E LOHMAN AVE, LAS CRUCES, NM 88011-8255
(575) 532-8900
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP000006912
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4355051811
MEDICARE ID NUMBER
NM
Enumeration date
08/20/2013
Last updated
01/14/2019
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