Healthcare Provider Details

I. General information

NPI: 1619633047
Provider Name (Legal Business Name): PATRICIA MARIE COOK RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2021
Last Update Date: 11/10/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N EIGHTY EIGHT RD
RICES LANDING PA
15357-1102
US

IV. Provider business mailing address

GIANT EAGLE CORP 101 KAPPA DRIVE
PITTSBURGH PA
15238
US

V. Phone/Fax

Practice location:
  • Phone: 724-592-6057
  • Fax: 724-592-7494
Mailing address:
  • Phone: 724-592-6057
  • Fax: 724-592-7494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP302704L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP032704L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: