MEDICARE: ELIZABETH ANN KIRBY PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	36737	TN

General Provider Information

NPI Number	:	1386999043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ANN KIRBY PHARMD

Provider Business Mailing Address
First Line	:	PO BOX 362
Second Line	:
City	:	SPARTA
State	:	TN
Zip	:	38583-0362
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 N SPRING ST
Second Line	:
City	:	SPARTA
State	:	TN
Zip	:	38583-1323
Country	:	US
Telephone Number	:	931-837-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2012
Last Update Date	:	06/20/2022

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