Provider Demographics
NPI:1174223325
Name:KOPP, SUZANNE BETH (PHARMD)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:BETH
Last Name:KOPP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:BETH
Other - Last Name:HIRSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12538 BEAVER CREEK ROAD
Mailing Address - Street 2:P.O. BOX 211
Mailing Address - City:PRINGLE
Mailing Address - State:SD
Mailing Address - Zip Code:57773
Mailing Address - Country:US
Mailing Address - Phone:605-673-2750
Mailing Address - Fax:
Practice Address - Street 1:505 N. RIVER ST.
Practice Address - Street 2:SUITE 2&3
Practice Address - City:HOT SPRINGS
Practice Address - State:SD
Practice Address - Zip Code:57747
Practice Address - Country:US
Practice Address - Phone:605-745-3320
Practice Address - Fax:605-745-3324
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR-5924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist