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General NPI Number Information
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NPI Number | 1821918012
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Entity Type | Organization
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Legal Business Name | DIRE WOLF SOLUTIONS LLC
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Dates
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Enumeration Date | 07/17/2026
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 2303 DAWSON RD STE 102D
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City | ALBANY
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State | GA
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Zip | 31707-2715
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Country | US
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Telephone | 229-255-6842
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 N SLAPPEY BLVD # 171
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City | ALBANY
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State | GA
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Zip | 31701-1001
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Country | US
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Telephone | 229-255-6842
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Fax |
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Authorized Official
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Title or Position | ORGANIZER
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Name | KENTERRIOUS BROOKS-MIMS
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Credential |
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Telephone | 229-255-6842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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