Healthcare Provider Details

I. General information

NPI: 1861316820
Provider Name (Legal Business Name): KOLBY COOK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4890 BARKSDALE BLVD
BOSSIER CITY LA
71112-4566
US

IV. Provider business mailing address

324 PRESERVE BLVD
BOSSIER CITY LA
71112-2081
US

V. Phone/Fax

Practice location:
  • Phone: 318-488-0896
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.026333
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: