OrganizationActive
Copperopolis Pharmacy
NPI 1164529459 · Community/Retail Pharmacy · Copperopolis, CA
Provider details
- NPI number
- 1164529459
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Kevin Tom, Owner(916) 394-1732
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
49 Cosmic Ct
Suite C
Copperopolis, CA 95228-9300
Phone: (209) 785-8787
Street-level locationGet directions
Mailing address
49 Cosmic Ct
Copperopolis, CA 95228-9300
Registry dates
- Enumerated
- 2006-09-20
- Last updated
- 2013-09-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.