Active NPI
Cozi Wilson, PHARMD
- Pharmacist
- Comanche, TX
National Provider Identifier
1164060745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 39257
- Practice address
- 404 W Central Ave
Comanche, TX 76442-2706 - Phone
- (325) 356-5276
- NPI assigned
- Dec 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 39257 | TX | Primary |
Addresses
Primary practice location
404 W Central Ave
Comanche, TX 76442-2706
Mailing address
404 W Central Ave
Comanche, TX 76442-2706
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81189 | Medicaid | TX |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | coziwilson@brookshires.com | BROOKSHIRE GROCERY COMPANY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39257 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1164060745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 W CENTRAL AVE",
"city": "COMANCHE",
"state": "TX",
"postal_code": "764422706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 W CENTRAL AVE",
"city": "COMANCHE",
"state": "TX",
"postal_code": "764422706",
"telephone_number": "325-356-5276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "COZI",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-14",
"last_updated": "2023-11-27",
"certification_date": "2019-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "TX",
"license": "39257",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "81189",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "coziwilson@brookshires.com",
"affiliation": "Y",
"affiliationName": "BROOKSHIRE GROCERY COMPANY",
"address_1": "404 W Central Ave",
"city": "Comanche",
"state": "TX",
"country_code": "US",
"postal_code": "764422706",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Comanche, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.