Provider Demographics
NPI:1487943999
Name:URICK, DOROTHY E
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:E
Last Name:URICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 DAWSON RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-2314
Mailing Address - Country:US
Mailing Address - Phone:229-432-0389
Mailing Address - Fax:229-432-7503
Practice Address - Street 1:2400 DAWSON RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2314
Practice Address - Country:US
Practice Address - Phone:229-432-0389
Practice Address - Fax:229-432-7503
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist