Provider Demographics
NPI:1063555761
Name:COOK, EMILY SWAN (PHARM D)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:SWAN
Last Name:COOK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ROBERT PRINCE RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37033
Mailing Address - Country:US
Mailing Address - Phone:931-729-4977
Mailing Address - Fax:
Practice Address - Street 1:146 E SWAN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37033-1446
Practice Address - Country:US
Practice Address - Phone:931-729-4977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13421183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist