Copperopolis Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

COPPEROPOLIS PHARMACY

Practice address

49 Cosmic CT
Suite C
Copperopolis, CA 95228-9300

Phone

(209) 785-8787

NPI assigned

Sep 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kevin Tom, PHARMD

Title

Owner

Phone

(916) 394-1732

Specialties & licenses 1

Addresses

Tax ID family

Copperopolis Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kevin S Tom

  • Community/Retail Pharmacy
  • Copperopolis, CA
  • NPI 1093140238
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378425600000",
    "number": "1164529459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 COSMIC CT",
            "address_2": "SUITE C",
            "city": "COPPEROPOLIS",
            "state": "CA",
            "postal_code": "952289300",
            "telephone_number": "209-785-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 COSMIC CT",
            "address_2": "SUITE C",
            "city": "COPPEROPOLIS",
            "state": "CA",
            "postal_code": "952289300",
            "telephone_number": "209-785-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPEROPOLIS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-09-06",
        "status": "A",
        "authorized_official_last_name": "TOM",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-394-1732",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin C Bremer, MS
• Broken Horse Rescue
• Sofia R. Bulahan, FNP
• Copperopolis Dental Kirandeep Kaur DDS Gen PTR
• Mark Scott Demanes, PH.D., MFT
• Jennifer Cathryn Dewey, RBT
• Polly Chrysanthemum Dodds
• Emotional and Behavioral Helath Services
• Richard Wesley French, DDS

• All providers in Copperopolis, CA
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.