Provider Demographics
NPI:1447605860
Name:COPELAND, STACIE SUE (RPH)
Entity Type:Individual
Prefix:MS
First Name:STACIE
Middle Name:SUE
Last Name:COPELAND
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 1:49288 GLENWILL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9360
Mailing Address - Country:US
Mailing Address - Phone:740-449-2150
Mailing Address - Fax:
Practice Address - Street 1:50789 VALLEY PLAZA DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1752
Practice Address - Country:US
Practice Address - Phone:740-695-5088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006029183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist