Provider Demographics
NPI:1093221632
Name:JOHNSON-COOK, JANICE (RPH)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:JOHNSON-COOK
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 1:117 LAMBERT RD
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-4449
Mailing Address - Country:US
Mailing Address - Phone:207-399-9127
Mailing Address - Fax:
Practice Address - Street 1:500 N HIGHWAY 90 BYP
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2204
Practice Address - Country:US
Practice Address - Phone:520-458-9690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS008338183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist