Provider Demographics
NPI:1922177203
Name:COOKE, ROBIN LANE (BS,PHARMD,CGP)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:LANE
Last Name:COOKE
Suffix:
Gender:F
Credentials:BS,PHARMD,CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 CHERRYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-7897
Mailing Address - Country:US
Mailing Address - Phone:704-544-5624
Mailing Address - Fax:704-544-2835
Practice Address - Street 1:SENIOR HEALTH CONNECTION
Practice Address - Street 2:7903 PROVIDENCE RD.
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277
Practice Address - Country:US
Practice Address - Phone:704-544-5624
Practice Address - Fax:704-544-2835
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC70401835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric