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General NPI Number Information
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NPI Number | 1114875739
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Entity Type | Individual
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Provider Name | THI LY
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Gender | Female
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 7101 US HIGHWAY 90 BLDG B
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City | DAPHNE
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State | AL
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Zip | 36526-9512
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Country | US
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Telephone | 251-279-5455
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Fax | 251-279-5475
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Provider Business Mailing Address
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Address Line | 2121 DORCHESTER DR
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City | MOBILE
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State | AL
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Zip | 36695-2920
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Country | US
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Telephone | 251-458-9886
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19480
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License Number State | AL
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