Provider Demographics
NPI:1710599139
Name:CORBIN, RAYNA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RAYNA
Middle Name:
Last Name:CORBIN
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 1:1609 FREMONT DR
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-2403
Mailing Address - Country:US
Mailing Address - Phone:192-751-2677
Mailing Address - Fax:719-276-2316
Practice Address - Street 1:1609 FREMONT DR
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2403
Practice Address - Country:US
Practice Address - Phone:719-275-1267
Practice Address - Fax:719-276-2312
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist