Cooke Food Store Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

COOKE FOOD STORE INC

Doing business as

Cooke's Pharmacy

Practice address

3400 Keith Street
Cleveland, TN 37312

Phone

(423) 472-6478

NPI assigned

Sep 13, 2019

Last updated

Sep 13, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

COOKE'S PHARMACYAs reported in NPPES

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

Authorized official

Name

Gina Marie Moser

Title

Director of Pharmacy

Phone

(423) 472-6478

Specialties & licenses 1

Addresses

Other names 1

• Cooke's Pharmacy Doing business as

Tax ID family

Cooke Food Store Inc2 organizations share this tax ID, including this one

Part of

Cooke Food Store Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• K-VA-T Food Stores, Inc

  dba Food City Pharmacy #743

  • Community/Retail Pharmacy
  • Cleveland, TN
  • NPI 1477806065
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William Andrew Bryson, PHARMD

  • Case Manager/Care Coordinator
  • Dalton, GA
  • NPI 1821341173
  NPD

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568332800000",
    "number": "1972153708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2365",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373202365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 KEITH STREET",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "37312",
            "telephone_number": "423-472-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOKE FOOD STORE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COOKE'S PHARMACY",
        "enumeration_date": "2019-09-13",
        "last_updated": "2019-09-13",
        "status": "A",
        "authorized_official_last_name": "MOSER",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "423-472-6478"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cooke's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Elizabeth Conn, LPC/MHSP
• Diego Constante Jr.
• Heidi Ozawa Contractor, MSPT
• Donna Shena Cook, RPH
• Margie Amanda Cook, FNP
• Mary A Cooke-Jones
• Alexandra Cooke, APRN
• Jacquelyn Marie Cooper, LADAC II
• Elizabeth Cope
• Lisa Cooper Copeland, MS CCC-SLP

• Long Term Care Pharmacy in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Long Term Care Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.