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General NPI Number Information
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NPI Number | 1013365055
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Entity Type | Organization
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Legal Business Name | COBB PHARMACY, INC
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Dates
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Enumeration Date | 06/01/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 3745 CHEROKEE ST NW SUITE 603
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City | KENNESAW
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State | GA
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Zip | 30144-6733
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Country | US
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Telephone | 404-252-8031
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Fax |
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Provider Business Mailing Address
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Address Line | 3745 CHEROKEE ST NW SUITE 603
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City | KENNESAW
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State | GA
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Zip | 30144-6733
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | SYLVIA RISHING
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Credential |
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Telephone | 404-258-8013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State | GA
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