Sai Coopers LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SAI COOPERS LLC

Practice address

3353 US Hwy 1
Vass, NC 28394

Phone

(910) 245-4672

Fax

(910) 245-3139

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Praveen Kumar Challa

Title

Pharmacist

Phone

(863) 602-0499

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• COOPERS PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nagakishore Babu Edupuganti, R.PH

  • Pharmacist
  • Fayetteville, NC
  • NPI 1255639845
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1962417592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661",
            "city": "VASS",
            "state": "NC",
            "postal_code": "283940661",
            "telephone_number": "910-245-4672",
            "fax_number": "910-245-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3353 US HWY 1",
            "city": "VASS",
            "state": "NC",
            "postal_code": "28394",
            "telephone_number": "910-245-4672",
            "fax_number": "910-245-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAI COOPERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "CHALLA",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "863-602-0499",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "11665",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0635193",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148442",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COOPERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Vass, NC
• Providers in Vass, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.