Individual
CODY OVERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
100 ADMIRAL TROST RD, COLUMBIA, IL 62236-1996
(618) 281-6400
Mailing address
100 ADMIRAL TROST RD, COLUMBIA, IL 62236-1996
(618) 281-6400
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.299539
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051.299539
STATE LICENSE
IL
Enumeration date
11/26/2020
Last updated
11/26/2020
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