Provider Demographics
NPI:1073552964
Name:COOTS, RODNEY M (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:M
Last Name:COOTS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2419
Mailing Address - Street 2:
Mailing Address - City:RAINSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35986-2419
Mailing Address - Country:US
Mailing Address - Phone:256-638-6667
Mailing Address - Fax:256-638-6658
Practice Address - Street 1:112 MAIN ST E
Practice Address - Street 2:
Practice Address - City:RAINSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35986-4555
Practice Address - Country:US
Practice Address - Phone:256-638-6667
Practice Address - Fax:256-638-6658
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist