Provider Demographics
NPI:1467524256
Name:DOBBINS DRUGS INC
Entity Type:Organization
Organization Name:DOBBINS DRUGS INC
Other - Org Name:DOBBINS DRUGS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:DOBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-946-6691
Mailing Address - Street 1:52 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:NY
Mailing Address - Zip Code:14489-1545
Mailing Address - Country:US
Mailing Address - Phone:315-946-6691
Mailing Address - Fax:315-946-4091
Practice Address - Street 1:52 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:NY
Practice Address - Zip Code:14489-1545
Practice Address - Country:US
Practice Address - Phone:315-946-6691
Practice Address - Fax:315-946-4091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0070393336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00472880Medicaid
2061067OtherPK
NY00472880Medicaid