=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770478695
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CANDACE COX PHARM D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2025
-----------------------------------------------------
Last Update Date | 06/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 880 MADISON AVE
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38103-3409
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-545-7970
-----------------------------------------------------
Fax | 901-545-8884
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 377 N WILLETT ST
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38112-5119
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-451-2108
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 43493
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------