Healthcare Provider Details

I. General information

NPI: 1205825635
Provider Name (Legal Business Name): SHARON DAVIDSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 US HIGHWAY 421 S
MC KEE KY
40447-9425
US

IV. Provider business mailing address

6600 HIGHWAY 490
EAST BERNSTADT KY
40729
US

V. Phone/Fax

Practice location:
  • Phone: 606-287-7104
  • Fax:
Mailing address:
  • Phone: 606-843-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number012702
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: