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General NPI Number Information
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NPI Number | 1235658030
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Entity Type | Organization
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Legal Business Name | COBB HOSPITAL INC
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Dates
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Enumeration Date | 09/12/2017
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 4441 ATLANTA RD SE STE 113
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City | SMYRNA
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State | GA
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Zip | 30080-6537
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Country | US
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Telephone | 470-956-0400
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Fax | 678-842-5530
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Provider Business Mailing Address
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Address Line | 4441 ATLANTA RD SE STE 113
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City | SMYRNA
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State | GA
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Zip | 30080-6537
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Country | US
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Telephone | 470-956-0400
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Fax | 678-842-5530
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KAREEMA DANELLA ABDUL-BARR
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Credential | RPH
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Telephone | 470-644-0392
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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 | PHRE010372
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License Number State | GA
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