Healthcare Provider Details

I. General information

NPI: 1912015835
Provider Name (Legal Business Name): MONICA ANN KOPP RPH, BCOP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6439 GARNERS FERRY RD
COLUMBIA SC
29209-1638
US

IV. Provider business mailing address

225 DAWN ISLAND TRL
CHAPIN SC
29036-8098
US

V. Phone/Fax

Practice location:
  • Phone: 803-776-4000
  • Fax: 803-695-6747
Mailing address:
  • Phone: 803-945-7347
  • Fax: 803-695-6747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-17548
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: