Provider Demographics
NPI:1649450008
Name:COPELAND, JOHN EVERITT JR (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:EVERITT
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 1:338 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:NY
Mailing Address - Zip Code:14810-1024
Mailing Address - Country:US
Mailing Address - Phone:607-776-4747
Mailing Address - Fax:607-776-2025
Practice Address - Street 1:338 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810-1024
Practice Address - Country:US
Practice Address - Phone:607-776-4747
Practice Address - Fax:607-776-2025
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist