Healthcare Provider Details
I. General information
NPI: 1275183188
Provider Name (Legal Business Name): DABBS DRUGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/13/2019
Last Update Date: 11/23/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
24968 MS HWY 15
MATHISTON MS
39752-6904
US
IV. Provider business mailing address
24968 MS HIGHWAY 15
MATHISTON MS
39752-6904
US
V. Phone/Fax
- Phone: 662-634-3061
- Fax: 662-634-3062
- Phone: 662-634-3061
- Fax: 662-634-3062
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
APRIL
SPEARMAN
DABBS
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 662-258-4422