Provider Demographics
NPI:1013002344
Name:IMPRIMIS UROLOGY PC
Entity Type:Organization
Organization Name:IMPRIMIS UROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:COPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-584-6300
Mailing Address - Street 1:1236 HUFFMAN MILL RD
Mailing Address - Street 2:SUITE 2550
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8700
Mailing Address - Country:US
Mailing Address - Phone:336-584-6300
Mailing Address - Fax:336-584-5366
Practice Address - Street 1:1236 HUFFMAN MILL RD
Practice Address - Street 2:SUITE 2550
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8700
Practice Address - Country:US
Practice Address - Phone:336-584-6300
Practice Address - Fax:336-584-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600894208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8924069Medicaid
G33349Medicare UPIN
2229159Medicare ID - Type Unspecified