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NPI Code Detail

MEDICARE: BRIAN MATTHEW COPPOLA PHARMD, R.PH

MEDICARE: BRIAN MATTHEW COPPOLA PHARMD, R.PH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH234050MA

General Provider Information

NPI Number : 1780273631
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN MATTHEW COPPOLA PHARMD, R.PH
Provider Business Mailing Address
First Line : 75 NICHOLAS RD APT I
Second Line :
City : FRAMINGHAM
State : MA
Zip : 01701-3449
Country : US
Telephone Number : 631-466-6916
Fax Number :
Provider Business Practice Location Address
First Line : 27 MAIN ST
Second Line :
City : WATERTOWN
State : MA
Zip : 02472-4404
Country : US
Telephone Number : 617-926-6660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2021
Last Update Date : 01/14/2021

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