Healthcare Provider Details

I. General information

NPI: 1093281818
Provider Name (Legal Business Name): PAUL COOK RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 10/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1238 NATIONAL PIKE
HOPWOOD PA
15445-2252
US

IV. Provider business mailing address

1238 NATIONAL PIKE
HOPWOOD PA
15445-2252
US

V. Phone/Fax

Practice location:
  • Phone: 724-437-2353
  • Fax:
Mailing address:
  • Phone: 724-437-2353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: