Provider Demographics
NPI:1427106475
Name:COOKS PHARMACY INC
Entity type:Organization
Organization Name:COOKS PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARROW
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:502-532-7388
Mailing Address - Street 1:PO BOX 708
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:KY
Mailing Address - Zip Code:40050-0708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:KY
Practice Address - Zip Code:40050
Practice Address - Country:US
Practice Address - Phone:502-845-2803
Practice Address - Fax:502-845-2834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP071553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1829879OtherNCPDP PROVIDER IDENTIFICATION NUMBER