=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093923096
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBBIE ANN SINCLAIR R.PH.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2007
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4478 MARKET ST.
-----------------------------------------------------
City | MARIANNA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32446-0000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-526-1800
-----------------------------------------------------
Fax | 850-526-1866
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1893 FAIRVIEW RD
-----------------------------------------------------
City | MARIANNA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32448-2620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-579-2136
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PS24164
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------