Provider Demographics
NPI:1639502826
Name:COCHRAN, JENNIFER (PHARM D)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 PUTTY HILL AVE
Mailing Address - Street 2:TARGET T1142
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5844
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1238 PUTTY HILL AVE
Practice Address - Street 2:TARGET T1142
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5844
Practice Address - Country:US
Practice Address - Phone:410-823-4543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist