Provider Demographics
NPI:1770250128
Name:FOUGHT, CODY (PHARM D)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:FOUGHT
Suffix:
Gender:M
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 1:39 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HUGHESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17737-1905
Mailing Address - Country:US
Mailing Address - Phone:570-220-4071
Mailing Address - Fax:
Practice Address - Street 1:201 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-6505
Practice Address - Country:US
Practice Address - Phone:570-320-8794
Practice Address - Fax:570-320-8796
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist