Provider Demographics
NPI:1598249161
Name:COLE, TROY FORREST (PH (PHARMACIST))
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:FORREST
Last Name:COLE
Suffix:
Gender:M
Credentials:PH (PHARMACIST)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 W 10TH AVE APT 101W
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4057
Mailing Address - Country:US
Mailing Address - Phone:509-936-3673
Mailing Address - Fax:
Practice Address - Street 1:1005 N STRATFORD RD
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-3512
Practice Address - Country:US
Practice Address - Phone:509-766-0168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60864204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist