MEDICARE: DR. BARRY J. COOK PHARMD, RPH

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	1835P1200X	Pharmacotherapy Pharmacist	28RIO1372300	NJ

General Provider Information

NPI Number	:	1942296587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY J. COOK PHARMD, RPH

Provider Business Mailing Address
First Line	:	913 BERESFORD WAY
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-6435
Country	:	US
Telephone Number	:	407-321-9711
Fax Number	:	407-792-6125

Provider Business Practice Location Address
First Line	:	913 BERESFORD WAY
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-6435
Country	:	US
Telephone Number	:	407-321-9711
Fax Number	:	407-792-6125

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	12/12/2010

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