Provider Demographics
NPI:1588775100
Name:POPE, TAMRA RENEE (RPH)
Entity type:Individual
Prefix:MS
First Name:TAMRA
Middle Name:RENEE
Last Name:POPE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 SW DEPUTY J DAVIS LN
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32024-3739
Mailing Address - Country:US
Mailing Address - Phone:386-752-3202
Mailing Address - Fax:
Practice Address - Street 1:297 N MARION AVE
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-2866
Practice Address - Country:US
Practice Address - Phone:386-752-1793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0032725183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist