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General NPI Number Information
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NPI Number | 1881333169
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Entity Type | Individual
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Provider Name | CAITLIN ANNE IRVIN
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Gender | Female
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Dates
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Enumeration Date | 06/03/2022
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 2940 W MAIN ST, DOTHAN, AL 36305
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City | DOTHAN
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State | AL
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Zip | 36305
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Country | US
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Telephone | 344-677-6149
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Fax |
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Provider Business Mailing Address
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Address Line | 209 N WASHINGTON ST
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City | COLUMBIA
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State | AL
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Zip | 36319-3535
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Country | US
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Telephone | 334-796-4604
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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 | 22363
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License Number State | AL
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