Healthcare Provider Details

I. General information

NPI: 1861227605
Provider Name (Legal Business Name): MICHEAL CHASE COCHRAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

8905 SW 78TH AVE
GAINESVILLE FL
32608-8735
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-1611
  • Fax:
Mailing address:
  • Phone: 307-331-0249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9261979
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number9261979
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code1835P1400X
TaxonomyPain Management Pharmacist
License Number9261979
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: