Provider Demographics
NPI:1144196403
Name:COBBS, CARLA
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:
Last Name:COBBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 THOMPSON AVE E
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-7064
Mailing Address - Country:US
Mailing Address - Phone:443-794-2066
Mailing Address - Fax:443-794-2066
Practice Address - Street 1:7550 TEAGUE RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1339
Practice Address - Country:US
Practice Address - Phone:443-794-2066
Practice Address - Fax:443-794-2066
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30266183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
568946544OtherBCBS
DC236Medicaid
5874OtherHEALTH PARTNERS