Provider Demographics
NPI:1821677154
Name:COPILOT PROVIDER SUPPORT SERVICES, LLC
Entity type:Organization
Organization Name:COPILOT PROVIDER SUPPORT SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:RUTHANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:855-272-1128
Mailing Address - Street 1:8700 E PINNACLE PEAK RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3586
Mailing Address - Country:US
Mailing Address - Phone:480-691-2000
Mailing Address - Fax:480-691-2001
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:480-691-2000
Practice Address - Fax:480-691-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy