Provider Demographics
NPI:1114264710
Name:COOLEY, JOSEPH ARTHUR (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ARTHUR
Last Name:COOLEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 PONCE DE LEON AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-4215
Mailing Address - Country:US
Mailing Address - Phone:404-898-0360
Mailing Address - Fax:404-898-0433
Practice Address - Street 1:1001 PONCE DE LEON AVE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-4215
Practice Address - Country:US
Practice Address - Phone:404-898-0360
Practice Address - Fax:404-898-0433
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH01279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist