Provider Demographics
NPI:1407578081
Name:COPPLER, TIMOTHY LEWIS (RPH)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LEWIS
Last Name:COPPLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 E BIGELOW ST
Mailing Address - Street 2:
Mailing Address - City:UPPER SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:43351-1122
Mailing Address - Country:US
Mailing Address - Phone:419-835-4736
Mailing Address - Fax:
Practice Address - Street 1:1815 W COUNTY ROAD 54
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-7723
Practice Address - Country:US
Practice Address - Phone:419-447-6216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03442301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist