=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083370290
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVIS NYARIKI
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2021
-----------------------------------------------------
Last Update Date | 11/21/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2200 US HIGHWAY 50 E
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89403-7352
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-246-0920
-----------------------------------------------------
Fax | 775-246-3918
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 645 S VIRGINIA ST APT 9
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89501-2374
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 701-200-0158
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 21796
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------