Healthcare Provider Details

I. General information

NPI: 1497310072
Provider Name (Legal Business Name): ADRIENNE COBB PHARM D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 DISCOVERY DR STE 200
CHARLOTTESVILLE VA
22911-5846
US

IV. Provider business mailing address

1725 DISCOVERY DR STE 200
CHARLOTTESVILLE VA
22911-5846
US

V. Phone/Fax

Practice location:
  • Phone: 434-297-6652
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number0202210716
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: