Organization
SAI COOPERS LLC
Active
Other names
COOPERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRAVEEN KUMAR CHALLA (PHARMACIST)
(863) 602-0499
Entity
Organization
Contact information
Practice address
3353 US HWY 1, VASS, NC 28394
(910) 245-4672
(910) 245-3139
Mailing address
PO BOX 661, VASS, NC 28394-0661
(910) 245-4672
(910) 245-4797
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
11665
NC
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0635193
—
NC
01
—
2148442
PK
—
Enumeration date
07/30/2006
Last updated
08/31/2021
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