Provider Demographics
NPI:1346305760
Name:SHIRLEY DOBBINS
Entity Type:Organization
Organization Name:SHIRLEY DOBBINS
Other - Org Name:TROY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:TOTTY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:731-536-4848
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:TN
Mailing Address - Zip Code:38260-0215
Mailing Address - Country:US
Mailing Address - Phone:731-536-4848
Mailing Address - Fax:731-536-6285
Practice Address - Street 1:404 E HARPER ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:TN
Practice Address - Zip Code:38260-5946
Practice Address - Country:US
Practice Address - Phone:731-536-4848
Practice Address - Fax:731-536-6285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
TN14153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2096143OtherPK
TN1455159Medicaid
2096143OtherPK