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General NPI Number Information
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NPI Number | 1548863780
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Entity Type | Individual
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Provider Name | TAMMY DORSEY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 30 ORVIN LANCE CONNECTOR
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City | BLUE RIDGE
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State | GA
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Zip | 30513-4238
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Country | US
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Telephone | 706-632-8097
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Fax |
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Provider Business Mailing Address
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Address Line | 442 REBECCA ST
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City | JASPER
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State | GA
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Zip | 30143-1100
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Country | US
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Telephone | 770-769-6040
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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 | RPH031519
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License Number State | GA
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