Provider Demographics
NPI:1174705123
Name:COPELAND, JOHN THOMAS (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:THOMAS
Last Name:COPELAND
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6040 TARBELL RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-1314
Mailing Address - Country:US
Mailing Address - Phone:888-843-2040
Mailing Address - Fax:888-842-3977
Practice Address - Street 1:6040 TARBELL RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-1314
Practice Address - Country:US
Practice Address - Phone:888-843-2040
Practice Address - Fax:888-842-3977
Is Sole Proprietor?:No
Enumeration Date:2007-12-01
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048658183500000X
NY045658-I183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist