Provider Demographics
NPI:1033678354
Name:COBB, ALLISON CLIPPARD (RPH)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:CLIPPARD
Last Name:COBB
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-2728
Mailing Address - Country:US
Mailing Address - Phone:704-825-5179
Mailing Address - Fax:704-825-1290
Practice Address - Street 1:682 PARK ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-2728
Practice Address - Country:US
Practice Address - Phone:704-825-5179
Practice Address - Fax:704-825-1290
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-16
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11723183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist