Provider Demographics
NPI:1821677154
Name:COPILOT PROVIDER SUPPORT SERVICES, LLC
Entity Type:Organization
Organization Name:COPILOT PROVIDER SUPPORT SERVICES, LLC
Other - Org Name:AUTOPILOT RX
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:SHEREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SARWAT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:855-272-1128
Mailing Address - Street 1:601 S LAKE DESTINY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7263
Mailing Address - Country:US
Mailing Address - Phone:855-272-1128
Mailing Address - Fax:
Practice Address - Street 1:8700 E PINNACLE PEAK RD STE 120
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3586
Practice Address - Country:US
Practice Address - Phone:408-691-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy