Provider Demographics
NPI:1053950212
Name:COODY, KARI (PHARM D)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:COODY
Suffix:
Gender:F
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 1:165 HARRIS CIR
Mailing Address - Street 2:
Mailing Address - City:COCHRAN
Mailing Address - State:GA
Mailing Address - Zip Code:31014-3701
Mailing Address - Country:US
Mailing Address - Phone:478-954-0689
Mailing Address - Fax:
Practice Address - Street 1:145 E PEACOCK ST
Practice Address - Street 2:
Practice Address - City:COCHRAN
Practice Address - State:GA
Practice Address - Zip Code:31014-7846
Practice Address - Country:US
Practice Address - Phone:478-934-6211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-04
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist