Healthcare Provider Details

I. General information

NPI: 1871497909
Provider Name (Legal Business Name): SHEPHERD THOMAS WOLFE CPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 SHUG JORDAN PKWY
AUBURN AL
36830-2926
US

IV. Provider business mailing address

141 HEMLOCK DR APT 212A
AUBURN AL
36832-7303
US

V. Phone/Fax

Practice location:
  • Phone: 334-539-6318
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberT76628
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: