Basic Information
Provider Information
NPI: 1841259330
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: TAMMY
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 445 CENTENNIAL AVE
Address2:  
City: BUTTE
State: MT
PostalCode: 597012870
CountryCode: US
TelephoneNumber: 4067234075
FaxNumber: 4064966035
Practice Location
Address1: 445 CENTENNIAL AVE
Address2:  
City: BUTTE
State: MT
PostalCode: 597012870
CountryCode: US
TelephoneNumber: 4064966029
FaxNumber: 4067234076
Other Information
ProviderEnumerationDate: 03/22/2006
LastUpdateDate: 03/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1835P1200X3545MTN Pharmacy Service ProvidersPharmacistPharmacotherapy
183500000X3545MTY Pharmacy Service ProvidersPharmacist 

No ID Information.


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