Most Relevant Information
Provider Data
| NPI Number: | 1003423989 |
| Provider Name: | CODY BRUCE RACHA PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 065663 |
Most Important Dates
| Enumeration Date: | 09/25/2020 |
| Last Updated: | 09/25/2020 |
Provider Practice Location
908 STATE ST
OGDENSBURG
NY
136693348
Practice Location Phone/Fax
| Phone: | 3153931714 |
| Fax: |
Provider Mailing Location
908 STATE ST
OGDENSBURG
NY
136693348
Provider Mailing Phone/Fax
| Phone: | 3153931714 |
| Fax: |