Provider Demographics
NPI:1265716567
Name:COPELAND, PATRICK WILLIAM JR (RPH)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:WILLIAM
Last Name:COPELAND
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3518 MAIN HWY
Mailing Address - Street 2:
Mailing Address - City:BAMBERG
Mailing Address - State:SC
Mailing Address - Zip Code:29003-1863
Mailing Address - Country:US
Mailing Address - Phone:803-245-7018
Mailing Address - Fax:803-245-3761
Practice Address - Street 1:3518 MAIN HWY
Practice Address - Street 2:
Practice Address - City:BAMBERG
Practice Address - State:SC
Practice Address - Zip Code:29003-1863
Practice Address - Country:US
Practice Address - Phone:803-245-7018
Practice Address - Fax:803-245-3761
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist