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General NPI Number Information
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NPI Number | 1265781686
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Entity Type | Individual
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Provider Name | COURTNEY ROSE POPP PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 8830 ALBEMARLE RD T1793
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City | CHARLOTTE
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State | NC
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Zip | 28227-2616
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Country | US
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Telephone | 704-264-0079
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Fax |
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Provider Business Mailing Address
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Address Line | 1109 E MOREHEAD ST APT 13
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City | CHARLOTTE
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State | NC
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Zip | 28204-2852
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Country | US
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Telephone | 248-255-8151
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302038931
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 23972
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License Number State | NC
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