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General NPI Number Information
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NPI Number | 1023087384
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Entity Type | Individual
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Provider Name | OUITA R DAVIS B.S. PHARMACY
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Gender | Female
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 350 E SIX FORKS RD
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City | RALEIGH
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State | NC
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Zip | 27609-7879
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Country | US
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Telephone | 919-559-2276
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Fax | 919-832-0837
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Provider Business Mailing Address
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Address Line | 723 LAKE BOONE TRL
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City | RALEIGH
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State | NC
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Zip | 27607-6603
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Country | US
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Telephone | 919-559-2276
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Fax | 919-832-0837
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10462
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202206255
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License Number State | VA
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