Basic Information
| Provider Information | |||||||||
| NPI: | 1669542940 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COPE | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | EDWARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD, BCPS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1185 DOLLY PARTON PKWY | ||||||||
| Address2: | |||||||||
| City: | SEVIERVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378623727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8652806113 | ||||||||
| FaxNumber: | 8652806250 | ||||||||
| Practice Location | |||||||||
| Address1: | 1185 DOLLY PARTON PKWY | ||||||||
| Address2: | |||||||||
| City: | SEVIERVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378623727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8652806113 | ||||||||
| FaxNumber: | 8652806250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 02/16/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 0000040054 | TN | Y | Pharmacy Service Providers | Pharmacist |
ID Information
| ID | Type | State | Issuer | Description | 0000040054 | 01 | TN | TENNESSEE BOARD OF PHARMACY | OTHER |