Healthcare Provider Details

I. General information

NPI: 1649054610
Provider Name (Legal Business Name): PAUL DAVEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 HARRISBURG AVE
LANCASTER PA
17603-2951
US

IV. Provider business mailing address

333 HARRISBURG AVE
LANCASTER PA
17603-2951
US

V. Phone/Fax

Practice location:
  • Phone: 717-740-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number30155114
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: