Provider Demographics
NPI:1659625846
Name:COPELAND, REBECCA BARR (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:BARR
Last Name:COPELAND
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 1:19354 SOLOMON BLATT AVE N
Mailing Address - Street 2:
Mailing Address - City:BLACKVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29817-2304
Mailing Address - Country:US
Mailing Address - Phone:803-284-3372
Mailing Address - Fax:803-284-3372
Practice Address - Street 1:19354 SOLOMON BLATT AVE N
Practice Address - Street 2:
Practice Address - City:BLACKVILLE
Practice Address - State:SC
Practice Address - Zip Code:29817-2304
Practice Address - Country:US
Practice Address - Phone:803-284-3372
Practice Address - Fax:803-284-3372
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC010236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist