Healthcare Provider Details

I. General information

NPI: 1801193610
Provider Name (Legal Business Name): HANNAH NICOLE DAVIS PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2011
Last Update Date: 02/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 W MAIN ST
DESHLER OH
43516-1159
US

IV. Provider business mailing address

1724 TIMBER RIDGE DR.
BOWLING GREEN OH
43402-1571
US

V. Phone/Fax

Practice location:
  • Phone: 419-278-1851
  • Fax: 419-278-8211
Mailing address:
  • Phone: 419-277-1502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03328752
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: