Provider Demographics
NPI:1538169842
Name:COOK, RENEE B (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:B
Last Name:COOK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CAROLE
Other - Middle Name:RENEE
Other - Last Name:BOHANNON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4710 HAMPTONS DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-2996
Mailing Address - Country:US
Mailing Address - Phone:770-888-1093
Mailing Address - Fax:678-298-3229
Practice Address - Street 1:95 COLLIER RD NW
Practice Address - Street 2:SUITE 5015
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1796
Practice Address - Country:US
Practice Address - Phone:404-350-9853
Practice Address - Fax:678-298-3229
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH019158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist