Provider Demographics
NPI:1508043936
Name:CODDINGTON, DARCY LEE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:DARCY
Middle Name:LEE
Last Name:CODDINGTON
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 1:645 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DE FOREST
Mailing Address - State:WI
Mailing Address - Zip Code:53532-1421
Mailing Address - Country:US
Mailing Address - Phone:608-846-4736
Mailing Address - Fax:608-846-6092
Practice Address - Street 1:645 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DE FOREST
Practice Address - State:WI
Practice Address - Zip Code:53532-1421
Practice Address - Country:US
Practice Address - Phone:608-846-4736
Practice Address - Fax:608-846-6092
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13478-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist