Healthcare Provider Details

I. General information

NPI: 1932022100
Provider Name (Legal Business Name): MARTHA DAVIS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6445 CALUMET AVE
HAMMOND IN
46324-1206
US

IV. Provider business mailing address

172 E SERENITY LN
SCHERERVILLE IN
46375-3113
US

V. Phone/Fax

Practice location:
  • Phone: 219-937-8521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26032116A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: