MEDICARE: DARRON W COOK

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
1	3747P1801X	Personal Care Attendant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487132650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRON W COOK

Provider Business Mailing Address
First Line	:	1140 N CAPITOL ST NW APT 311
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-7554
Country	:	US
Telephone Number	:	202-427-3095
Fax Number	:

Provider Business Practice Location Address
First Line	:	865 XENIA ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20032-3971
Country	:	US
Telephone Number	:	202-717-3507
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2018
Last Update Date	:	07/31/2018

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Directions to “ DARRON W COOK ” Practice Location

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