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General NPI Number Information
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NPI Number | 1932895273
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Entity Type | Individual
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Provider Name | MIRANDA LYNN KOPFMAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 109 BEE ST
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City | CHARLESTON
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State | SC
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Zip | 29401-5703
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Country | US
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Telephone | 843-789-6526
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Fax |
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Provider Business Mailing Address
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Address Line | 3138 HUGH BENNETT DR
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City | JOHNS ISLAND
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State | SC
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Zip | 29455-3473
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 051304429
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License Number State | IL
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