Cobra Pharmacy, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

02242120003 Issued in OH

Legal business name

COBRA PHARMACY, LLC

Doing business as

Holbrook's Hometown Pharmacy

Practice address

37 C Lucasville-Minford Road
Lucasville, OH 45648

Phone

(740) 357-8426

NPI assigned

Sep 15, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brandon Lee Holbrook, PHARMD, RPHNPI 1255829354

Title

Member/Pharmacist in Charge

Phone

(740) 357-8426

Specialties & licenses 1

Addresses

Other names 1

• Holbrook's Hometown Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brandon Lee Holbrook, RPH, PHARMD

  • Pharmacist
  • Lucasville, OH
  • NPI 1255829354
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524787200000",
    "number": "1558762138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37C LUCASVILLE MINFORD RD",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "456489023",
            "telephone_number": "740-259-0041",
            "fax_number": "740-259-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 C LUCASVILLE-MINFORD ROAD",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "45648",
            "telephone_number": "740-357-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBRA PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-15",
        "last_updated": "2018-04-27",
        "status": "A",
        "authorized_official_last_name": "HOLBROOK",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MEMBER/PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "740-357-8426",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD, RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OH",
            "license": "02242120003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holbrook's Hometown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Holbrook's Hometown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Lynn Call-James, LPN
• Lendy Ann Caudill, LPN
• Christopher E Holbrook Sr (Beacon Home Medical Supply)
• Beverly S Clark
• Clinical Pharmacy Services, LLC (Gahm's Pharmacy)
• Erin Colley, OTR/L
• Herman L Colley III
• Rosa N Coriell, PTA
• Adrienne Cottrill
• Krista Lynn Crabtree

• Pharmacy in Lucasville, OH
• Providers in Lucasville, OH by specialty
• Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.