Provider Demographics
NPI:1235424425
Name:COX, SHONNA MALONE (RPH)
Entity Type:Individual
Prefix:MS
First Name:SHONNA
Middle Name:MALONE
Last Name:COX
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 1:1591 BRADLEY PARK DR
Mailing Address - Street 2:T1179 PHARMACY
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-3071
Mailing Address - Country:US
Mailing Address - Phone:706-327-8201
Mailing Address - Fax:
Practice Address - Street 1:1591 BRADLEY PARK DR
Practice Address - Street 2:T1179 PHARMACY
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-3071
Practice Address - Country:US
Practice Address - Phone:706-327-8201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist