George Copenhaver

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Burlington, KY

NPI 1356973408 · NPPES record last updated Feb 6, 2020

Key facts

NPI
1356973408
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
018497 (KY)
Practice address
1751 Patrick Dr
Burlington, KY 41005-7345
Phone
(859) 586-4692
Fax
(859) 586-2860
NPI assigned
Feb 6, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
018497KYMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
03135723OHMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I Past
since Feb 9, 2020
Accepting new patients
Kroger Limited Partnership I Past
since Feb 9, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 03135723 OH
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 018497 KY Yes

Addresses

Primary practice location

1751 Patrick Dr
Burlington, KY 41005-7345

Mailing address

1751 Patrick Dr
Burlington, KY 41005-7345
Phone (859) 586-4692

Other providers in Burlington, KY

All providers in Burlington, KY · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Kentucky

Sources for this page

Verify at the official NPI Registry.