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MR. KENNETH JAMES DAVIS PHARMACIST
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1760499198
Individual Registrant:MR. KENNETH JAMES DAVIS PHARMACIST
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
326 DOYLE ST W TOCCOA, GA 30577-2314 US
Tel: 706-886-7422 Fax: --
Tel: 706-886-7422 Fax: --
Contact information for business:
326 DOYLE ST W TOCCOA, GA 30577-2314 US
Tel: 706-886-7422 Fax: --
Tel: 706-886-7422 Fax: --
Registration Information:
NPI: 1760499198
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | GA | 09035 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| PHARMACY LICENCE NUMBER | 09035 | GA | 01 |
