Provider Demographics
NPI:1427168228
Name:COPE, BEECHER RAY JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BEECHER
Middle Name:RAY
Last Name:COPE
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1112 MARTINELLI DR
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-4910
Mailing Address - Country:US
Mailing Address - Phone:505-870-7282
Mailing Address - Fax:928-729-8348
Practice Address - Street 1:CORNER OF ROUTES N12 AND N7
Practice Address - Street 2:
Practice Address - City:FORT DEFIANCE
Practice Address - State:AZ
Practice Address - Zip Code:86504
Practice Address - Country:US
Practice Address - Phone:928-729-8984
Practice Address - Fax:928-729-8348
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS09194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist