NPI 1134894660

Samantha Coppola

Practitioner Pharmacist Vicksburg, MS

Practice location

Address: 3341 Halls Ferry Rd, Vicksburg, MS 39180-5338
Phone: (601) 661-9340
Mailing address: 1707 East Ave, Vicksburg, MS 39180-3722

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence E-100344 (MS)

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Registry record

NPI: 1134894660
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Aug 2021
Record last updated: 16 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.