MEDICARE: JANET R. COOK RPH..

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH00015881	WA

General Provider Information

NPI Number	:	1285606939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET R. COOK RPH..

Provider Business Mailing Address
First Line	:	PO BOX 460
Second Line	:
City	:	INDIANOLA
State	:	WA
Zip	:	98342-0460
Country	:	US
Telephone Number	:	360-598-6570
Fax Number	:	360-394-1012

Provider Business Practice Location Address
First Line	:	19379 7TH AVE NE
Second Line	:
City	:	POULSBO
State	:	WA
Zip	:	98370-7504
Country	:	US
Telephone Number	:	360-394-1005
Fax Number	:	360-394-1012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	07/08/2007

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