Provider Demographics
NPI:1912017351
Name:COOK, DAWN RENEE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:RENEE
Last Name:COOK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 DUENKE RD
Mailing Address - Street 2:
Mailing Address - City:FORISTELL
Mailing Address - State:MO
Mailing Address - Zip Code:63348-1128
Mailing Address - Country:US
Mailing Address - Phone:636-448-6527
Mailing Address - Fax:636-925-1295
Practice Address - Street 1:2855 VETERANS MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-3526
Practice Address - Country:US
Practice Address - Phone:636-925-1143
Practice Address - Fax:636-925-1295
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002000530183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist