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Organization
COGBURN HEALTH CENTER PHARMACY
Active
Organization
COGBURN HEALTH CENTER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONNIE CANNON RPH (DIRECTOR OF PHARMACY)
(251) 476-4941
Entity
Organization
Contact information
Practice address
2651 CAMERON ST, SUITE F, MOBILE, AL 36607-3127
(251) 476-4941
(251) 476-4780
Mailing address
2651 CAMERON ST, SUITE F, MOBILE, AL 36607-3127
(251) 476-4941
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
120095
AL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108161
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
100100049
—
AL
Enumeration date
07/14/2006
Last updated
06/20/2008
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