Provider Demographics
NPI:1912333956
Name:COCHRAN, CARMAN G (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:CARMAN
Middle Name:G
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:CARMAN
Other - Middle Name:
Other - Last Name:WALLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:68 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:MC LAIN
Mailing Address - State:MS
Mailing Address - Zip Code:39456-2330
Mailing Address - Country:US
Mailing Address - Phone:601-525-3468
Mailing Address - Fax:601-766-4293
Practice Address - Street 1:68 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:MC LAIN
Practice Address - State:MS
Practice Address - Zip Code:39456-2330
Practice Address - Country:US
Practice Address - Phone:601-525-3468
Practice Address - Fax:601-766-4293
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-73311835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist