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NPI Code Detail

MEDICARE: MARC IRA COHEN PHARMD

MEDICARE: MARC IRA COHEN PHARMD
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
1183500000XPharmacistPS42445FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11639184872OTHERWALGREENS

General Provider Information

NPI Number : 1922288109
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARC IRA COHEN PHARMD
Provider Business Mailing Address
First Line : 2501 VIRGINIA AVE
Second Line :
City : FORT PIERCE
State : FL
Zip : 34981-5588
Country : US
Telephone Number : 561-445-9287
Fax Number :
Provider Business Practice Location Address
First Line : 2501 VIRGINIA AVE
Second Line :
City : FORT PIERCE
State : FL
Zip : 34981-5588
Country : US
Telephone Number : 561-445-9287
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2007
Last Update Date : 12/23/2022

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Directions to “ MARC IRA COHEN PHARMD” Practice Location

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