Walter Allan Cooley
Individual provider Active NPI Pharmacist · Oakdale, CA
NPI 1124533419 · NPPES record last updated Dec 7, 2017
Key facts
- NPI
- 1124533419
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 36547 (CA)
- Practice address
- 1080 W F St
Oakdale, CA 95361-3677 - Phone
- (209) 847-2226
- Fax
- (209) 847-2226
- NPI assigned
- Dec 7, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36547 | CA | Yes |
Addresses
Primary practice location
1080 W F St
Oakdale, CA 95361-3677
Mailing address
912 Northfield CT
Modesto, CA 95350-2180
Phone (209) 526-5023
Other providers in Oakdale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.