Provider Demographics
NPI:1548241383
Name:MANUS, COZETTE WEST (PHARM D)
Entity Type:Individual
Prefix:
First Name:COZETTE
Middle Name:WEST
Last Name:MANUS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 MORRIS DR
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37030-2159
Mailing Address - Country:US
Mailing Address - Phone:615-735-0068
Mailing Address - Fax:
Practice Address - Street 1:1210 MAIN ST N
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030-1037
Practice Address - Country:US
Practice Address - Phone:615-735-2223
Practice Address - Fax:615-735-1077
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist