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General NPI Number Information
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NPI Number | 1063566412
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Entity Type | Organization
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Legal Business Name | COOKES PHARMACY INC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 03/27/2009
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Provider Practice Location Address
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Address Line | 1207 W FRONT ST
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City | STATESVILLE
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State | NC
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Zip | 28677-5052
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Country | US
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Telephone | 704-873-9498
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Fax | 704-873-7483
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Provider Business Mailing Address
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Address Line | 1207 W FRONT ST
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City | STATESVILLE
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State | NC
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Zip | 28677-5052
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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 | PHCST OWNER
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Name | DONNIE BOWERS
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Credential | RPH
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Telephone | 704-872-6402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 05240
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License Number State | NC
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