Provider Demographics
NPI:1568057149
Name:COBER, MARY PETREA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:PETREA
Last Name:COBER
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 1:6623 BEXLEY CT
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-6533
Mailing Address - Country:US
Mailing Address - Phone:216-288-2716
Mailing Address - Fax:
Practice Address - Street 1:AKRON CHILDREN'S HOSPITAL, DEPARTMENT OF PHARMACY
Practice Address - Street 2:ONE PERKINS SQUARE
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308
Practice Address - Country:US
Practice Address - Phone:330-543-3024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03130011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist