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General NPI Number Information
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NPI Number | 1760167647
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Entity Type | Individual
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Provider Name | ALLISON ANN COTTA IMMUNIZING CPHT
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Gender | Female
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 1102 N QUEEN ST
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City | MARTINSBURG
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State | WV
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Zip | 25404-3603
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Country | US
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Telephone | 304-260-9185
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Fax |
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Provider Business Mailing Address
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Address Line | 120 CHECKO CT
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City | MARTINSBURG
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State | WV
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Zip | 25401-1815
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Country | US
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Telephone | 304-620-1138
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | T27597
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | PT0011200
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License Number State | WV
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