Provider Demographics
NPI:1235658030
Name:COBB HOSPITAL INC
Entity Type:Organization
Organization Name:COBB HOSPITAL INC
Other - Org Name:WELLSTAR PHARMACY NETWORK #9
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREEMA
Authorized Official - Middle Name:DANELLA
Authorized Official - Last Name:ABDUL-BARR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:470-644-0392
Mailing Address - Street 1:4441 ATLANTA RD SE STE 113
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6537
Mailing Address - Country:US
Mailing Address - Phone:470-956-0400
Mailing Address - Fax:678-842-5530
Practice Address - Street 1:4441 ATLANTA RD SE STE 113
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6537
Practice Address - Country:US
Practice Address - Phone:470-956-0400
Practice Address - Fax:678-842-5530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE010372333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy