MEDICARE: DR. RENEE B COOK 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
1	183500000X	Pharmacist	RPH019158	GA

General Provider Information

NPI Number	:	1538169842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENEE B COOK PHARM.D.

Provider Business Mailing Address
First Line	:	4710 HAMPTONS DR
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-2996
Country	:	US
Telephone Number	:	770-888-1093
Fax Number	:	678-298-3229

Provider Business Practice Location Address
First Line	:	95 COLLIER RD NW
Second Line	:	SUITE 5015
City	:	ATLANTA
State	:	GA
Zip	:	30309-1796
Country	:	US
Telephone Number	:	404-350-9853
Fax Number	:	678-298-3229

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/08/2007

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