Provider Demographics
NPI:1588704001
Name:CODY, DAVID EMMETT III (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:EMMETT
Last Name:CODY
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 18TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-1824
Mailing Address - Country:US
Mailing Address - Phone:828-327-4209
Mailing Address - Fax:
Practice Address - Street 1:1985 STARTOWN RD
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-8307
Practice Address - Country:US
Practice Address - Phone:828-328-1169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist