NPIMap

Organization Active NPI

Copac, Inc.

  • Substance Abuse Rehabilitation Facility
  • Brandon, MS
National Provider Identifier
1235270885
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
FS39DADAPRTR01 Issued in MS
Legal business name
COPAC, INC.
Practice address
3949 Highway 43 N
Brandon, MS 39047-7240
Phone
(601) 829-2500
Fax
(601) 829-4278
NPI assigned
Feb 8, 2007
Last updated
Dec 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Tom Kepner
Title
Director of Operations
Phone
(601) 829-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X FS39DADAPRTR01 MS Primary

Addresses

Primary practice location

3949 Highway 43 N
Brandon, MS 39047-7240

Mailing address

3949 Highway 43 N
Brandon, MS 39047-7240
Phone (601) 829-2500

Other names 1

  • COPAC Addiction Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Copac Addiction Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1235270885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 HIGHWAY 43 N",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477240",
            "telephone_number": "601-829-2500",
            "fax_number": "601-829-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 HIGHWAY 43 N",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477240",
            "telephone_number": "601-829-2500",
            "fax_number": "601-829-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPAC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "KEPNER",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "601-829-2500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MS",
            "license": "FS39DADAPRTR01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COPAC Addiction Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.