Individual ProviderTara Renae CockerhamPharmacistPharmacy Service ProvidersPractice Address1121 Alderman Dr, Suite 112, Alpharetta, GA 30005-5463(678) 672-4209PECOS EnrollmentBased on the most recent information from CMS, provider Tara Renae Cockerham does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1730425091Provider TypeIndividualFull NameCockerham, Tara RenaeTitleDr.CredentialPHARMDGenderFemaleSole ProprietorYesEnumeration Date12/13/2012Last Updated12/13/2012Contact InformationPractice LocationPractice Address1121 Alderman Dr, Suite 112, Alpharetta, GA 30005-5463Phone(678) 672-4209Fax(678) 672-4199Mailing LocationMailing Address1121 Alderman Dr, Suite 112, Alpharetta, GA 30005-5463Phone(678) 672-4209Fax(678) 672-4199Provider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicenseRPH020402Georgia