Provider Demographics
NPI:1275199259
Name:COPE, AMY B (RPH)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:COPE
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 1:7865 W US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-9345
Mailing Address - Country:US
Mailing Address - Phone:719-539-6614
Mailing Address - Fax:719-539-9830
Practice Address - Street 1:7865 W US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-9345
Practice Address - Country:US
Practice Address - Phone:719-539-6614
Practice Address - Fax:719-539-9830
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist