Provider Demographics
NPI:1841423779
Name:COOPER, HEATHER (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 314
Mailing Address - Street 2:
Mailing Address - City:ADAMSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38310-0314
Mailing Address - Country:US
Mailing Address - Phone:731-632-3278
Mailing Address - Fax:731-632-3279
Practice Address - Street 1:712 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:ADAMSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38310
Practice Address - Country:US
Practice Address - Phone:731-632-3278
Practice Address - Fax:731-632-3279
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26690183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist