Provider Demographics
NPI:1326691627
Name:COCKERILL, DENNIS EUGENE (RPH)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:EUGENE
Last Name:COCKERILL
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 1:1990 HARMON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-3829
Mailing Address - Country:US
Mailing Address - Phone:614-441-0513
Mailing Address - Fax:614-445-7041
Practice Address - Street 1:1990 HARMON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-3829
Practice Address - Country:US
Practice Address - Phone:614-441-0513
Practice Address - Fax:614-445-7041
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031175651835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N1003XPharmacy Service ProvidersPharmacistNutrition Support