Provider Demographics
NPI:1306820246
Name:COOPER DRUGS INC
Entity Type:Organization
Organization Name:COOPER DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:VOSKUHL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:812-256-4324
Mailing Address - Street 1:830 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111-1220
Mailing Address - Country:US
Mailing Address - Phone:812-256-2500
Mailing Address - Fax:812-256-7856
Practice Address - Street 1:830 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:IN
Practice Address - Zip Code:47111-1220
Practice Address - Country:US
Practice Address - Phone:812-256-2500
Practice Address - Fax:812-256-7856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200464230AMedicaid
IN200464230Medicaid