Provider Demographics
NPI:1437500626
Name:COEN, REBECCA WEBB (PHARMD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:WEBB
Last Name:COEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 E 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015
Mailing Address - Country:US
Mailing Address - Phone:229-273-5043
Mailing Address - Fax:229-273-5076
Practice Address - Street 1:1024 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-1538
Practice Address - Country:US
Practice Address - Phone:229-273-5043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist