Provider Demographics
NPI:1033487293
Name:COOPER, JOANIE M (RPH)
Entity Type:Individual
Prefix:MS
First Name:JOANIE
Middle Name:M
Last Name:COOPER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3116 HEYBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-5835
Mailing Address - Country:US
Mailing Address - Phone:770-667-8033
Mailing Address - Fax:
Practice Address - Street 1:3116 HEYBRIDGE LN
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-5835
Practice Address - Country:US
Practice Address - Phone:770-667-8033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH025814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist