Provider Demographics
NPI:1427644848
Name:COGGINS, STEVEN B X (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:COGGINS
Suffix:X
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 1:2698 HIGHWAY 145
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-6941
Mailing Address - Country:US
Mailing Address - Phone:662-269-2781
Mailing Address - Fax:662-269-2037
Practice Address - Street 1:2698 HIGHWAY 145
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-6941
Practice Address - Country:US
Practice Address - Phone:662-269-2781
Practice Address - Fax:662-269-2037
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-09895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist