Provider Demographics
NPI:1154758860
Name:COOK, DAVID BRIGHAM (PHARMD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BRIGHAM
Last Name:COOK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 N GATEWAY DR STE 803
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-9004
Mailing Address - Country:US
Mailing Address - Phone:435-752-2665
Mailing Address - Fax:
Practice Address - Street 1:435 N GATEWAY DR STE 803
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9004
Practice Address - Country:US
Practice Address - Phone:435-752-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0013807183500000X
UT5917009183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist