Provider Demographics
NPI:1114300969
Name:COFFEY, CORY PATRICK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:PATRICK
Last Name:COFFEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 WENDEMERE DR
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-2620
Mailing Address - Country:US
Mailing Address - Phone:330-719-7309
Mailing Address - Fax:
Practice Address - Street 1:1400 S ARLINGTON ST
Practice Address - Street 2:SUITE 38
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-3750
Practice Address - Country:US
Practice Address - Phone:330-724-5471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03334606183500000X
OH06010561183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist