MEDICARE: COX PHARMACY INC.

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	3336C0003X	Community/Retail Pharmacy
2	183500000X	Pharmacist	PHRE006069	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1127326	OTHER		NATIONAL PROVIDER ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316081045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COX PHARMACY INC.

Provider Business Mailing Address
First Line	:	300 2ND AVE SE
Second Line	:
City	:	CAIRO
State	:	GA
Zip	:	39828-2726
Country	:	US
Telephone Number	:	229-377-9017
Fax Number	:	229-377-3994

Provider Business Practice Location Address
First Line	:	300 2ND AVE SE
Second Line	:
City	:	CAIRO
State	:	GA
Zip	:	39828-2726
Country	:	US
Telephone Number	:	229-377-9017
Fax Number	:	229-377-3994

Authorized Official
Title or Position	:	OWNER
Name	:	JEFFREY FRED COX
Credential	:
Telephone Number	:	229-377-9017

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	12/09/2019

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Directions to “COX PHARMACY INC. ” Practice Location

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