MEDICARE: MS. ROBERTA JEAN COX R.PH

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	PS0039742	FL
2	183500000X	Pharmacist	03-2-26145	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770693780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROBERTA JEAN COX R.PH

Provider Business Mailing Address
First Line	:	12684 W CRYSTALVUE LANE
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34428
Country	:	US
Telephone Number	:	352-447-2972
Fax Number	:

Provider Business Practice Location Address
First Line	:	3711 E SILVER SPRINGS BLVD
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34470-4903
Country	:	US
Telephone Number	:	352-694-4111
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/15/2010

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