Provider Demographics
NPI:1598321879
Name:COOPER, JULIETTE BATES (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIETTE
Middle Name:BATES
Last Name:COOPER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27268-4260
Mailing Address - Country:US
Mailing Address - Phone:336-841-9667
Mailing Address - Fax:
Practice Address - Street 1:319 WESTWOOD AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4323
Practice Address - Country:US
Practice Address - Phone:336-878-6419
Practice Address - Fax:336-878-6420
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16419183500000X
NC7001871835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist