Provider Demographics
NPI:1689852923
Name:COSME, ROBERT E (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:COSME
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 S 90TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-1822
Mailing Address - Country:US
Mailing Address - Phone:253-539-7990
Mailing Address - Fax:253-539-7994
Practice Address - Street 1:2111 S 90TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-1822
Practice Address - Country:US
Practice Address - Phone:253-539-7990
Practice Address - Fax:253-539-7994
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00014536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist