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NPI Code Detail

MEDICARE: DR. SHANNON ELIZABETH COZORT PHARM D

MEDICARE: DR. SHANNON ELIZABETH COZORT PHARM D
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
1183500000XPharmacist20646NC

General Provider Information

NPI Number : 1336430859
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANNON ELIZABETH COZORT PHARM D
Provider Business Mailing Address
First Line : 7444 PEBBLESTONE DR APT C
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-0050
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2325 VILLAGE LAKE DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-0081
Country : US
Telephone Number : 704-536-3663
Fax Number : 704-532-8879
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2011
Last Update Date : 05/02/2011

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