Provider Demographics
NPI:1023389665
Name:COBURN, TARINA ASHA JAIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:TARINA
Middle Name:ASHA JAIN
Last Name:COBURN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 6TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4009
Mailing Address - Country:US
Mailing Address - Phone:256-355-4495
Mailing Address - Fax:
Practice Address - Street 1:1127 6TH AVE SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4009
Practice Address - Country:US
Practice Address - Phone:256-355-4495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist