Provider Demographics
NPI:1578213054
Name:GOSS, DABNEY (RPH)
Entity Type:Individual
Prefix:
First Name:DABNEY
Middle Name:
Last Name:GOSS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 PEBBLE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-3617
Mailing Address - Country:US
Mailing Address - Phone:770-235-7740
Mailing Address - Fax:
Practice Address - Street 1:312 PEBBLE BEACH DR
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-3617
Practice Address - Country:US
Practice Address - Phone:770-235-7740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-27
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11919183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist