Provider Demographics
NPI:1255851044
Name:COOPER, CASH ARMSTRONG (DPH)
Entity Type:Individual
Prefix:
First Name:CASH
Middle Name:ARMSTRONG
Last Name:COOPER
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 W KENOSHA ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-8511
Mailing Address - Country:US
Mailing Address - Phone:918-249-0214
Mailing Address - Fax:918-249-0230
Practice Address - Street 1:4901 W KENOSHA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-8511
Practice Address - Country:US
Practice Address - Phone:918-249-0214
Practice Address - Fax:918-249-0230
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK16220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist