Healthcare Provider Details

I. General information

NPI: 1831706415
Provider Name (Legal Business Name): CARMEN VIVIAN DAVIS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2020
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 CENTERVILLE RD
WILMINGTON DE
19808-6220
US

IV. Provider business mailing address

1344 CLIFFORD RD
WILMINGTON DE
19805-1314
US

V. Phone/Fax

Practice location:
  • Phone: 302-994-3848
  • Fax:
Mailing address:
  • Phone: 305-890-9957
  • Fax: 866-477-4877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS57282
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0015765
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03911200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: