Provider Demographics
NPI:1043587017
Name:COOK, ADRIAN R (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:R
Last Name:COOK
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25302 ISLAND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MN
Mailing Address - Zip Code:55721-2115
Mailing Address - Country:US
Mailing Address - Phone:218-327-2599
Mailing Address - Fax:
Practice Address - Street 1:421 PAUL BUNYAN DR NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-2435
Practice Address - Country:US
Practice Address - Phone:218-333-4032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist