Healthcare Provider Details

I. General information

NPI: 1346305760
Provider Name (Legal Business Name): SHIRLEY DOBBINS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 E HARPER ST
TROY TN
38260-5946
US

IV. Provider business mailing address

PO BOX 215
TROY TN
38260-0215
US

V. Phone/Fax

Practice location:
  • Phone: 731-536-4848
  • Fax: 731-536-6285
Mailing address:
  • Phone: 731-536-4848
  • Fax: 731-536-6285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1415
License Number StateTN

VIII. Authorized Official

Name: KRISTI TOTTY
Title or Position: PHARMACIST-IN-CHARGE
Credential: PHARMD
Phone: 731-536-4848