Provider Demographics
NPI:1427230499
Name:COBB, JANNA H (RPH)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:H
Last Name:COBB
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 1:207 W GEER ST
Mailing Address - Street 2:
Mailing Address - City:COLQUITT
Mailing Address - State:GA
Mailing Address - Zip Code:39837-3533
Mailing Address - Country:US
Mailing Address - Phone:229-758-3316
Mailing Address - Fax:229-758-6343
Practice Address - Street 1:207 W GEER ST
Practice Address - Street 2:
Practice Address - City:COLQUITT
Practice Address - State:GA
Practice Address - Zip Code:39837-3533
Practice Address - Country:US
Practice Address - Phone:229-758-3316
Practice Address - Fax:229-758-6343
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17578183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist