Provider Demographics
NPI:1427661875
Name:CHIARAMONTE, CODY FRANK (PHARMD)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:FRANK
Last Name:CHIARAMONTE
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 1:2172 N BUCKBOARD DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-9705
Mailing Address - Country:US
Mailing Address - Phone:435-592-0777
Mailing Address - Fax:
Practice Address - Street 1:1235 W STATE ST
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-3539
Practice Address - Country:US
Practice Address - Phone:435-635-1071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6538360-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist