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NPI Code Detail

MEDICARE: DR. JORDAN RAE COCHRAN HODGES PHARMD

MEDICARE: DR. JORDAN RAE COCHRAN HODGES PHARMD
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
1183500000XPharmacist17936AL

General Provider Information

NPI Number : 1114315199
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORDAN RAE COCHRAN HODGES PHARMD
Provider Business Mailing Address
First Line : 4373 NORTHCREEK BLVD
Second Line :
City : NORTHPORT
State : AL
Zip : 35473-2171
Country : US
Telephone Number : 800-489-3636
Fax Number : 866-680-7046
Provider Business Practice Location Address
First Line : 4373 NORTHCREEK BLVD
Second Line :
City : NORTHPORT
State : AL
Zip : 35473-2171
Country : US
Telephone Number : 800-489-3636
Fax Number : 866-680-7046
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2014
Last Update Date : 11/22/2020

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