Provider Demographics
NPI:1598553133
Name:KAUP PHARMACY, INC.
Entity type:Organization
Organization Name:KAUP PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-733-0117
Mailing Address - Street 1:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:FORT RECOVERY
Mailing Address - State:OH
Mailing Address - Zip Code:45846-0605
Mailing Address - Country:US
Mailing Address - Phone:419-375-2323
Mailing Address - Fax:419-375-4488
Practice Address - Street 1:257 E 4TH ST STE B
Practice Address - Street 2:
Practice Address - City:MINSTER
Practice Address - State:OH
Practice Address - Zip Code:45865-1311
Practice Address - Country:US
Practice Address - Phone:567-603-0600
Practice Address - Fax:567-603-0700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAUP PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies