Provider Demographics
NPI:1164937488
Name:COELHO, TANYA TRAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:TRAN
Last Name:COELHO
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 1:6723 SANDPIPER CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-7178
Mailing Address - Country:US
Mailing Address - Phone:301-814-8117
Mailing Address - Fax:
Practice Address - Street 1:2 THURMONT BLVD
Practice Address - Street 2:
Practice Address - City:THURMONT
Practice Address - State:MD
Practice Address - Zip Code:21788-2000
Practice Address - Country:US
Practice Address - Phone:301-271-2548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-08
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist