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General NPI Number Information
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NPI Number | 1245520923
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Entity Type | Individual
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Provider Name | MIRANDA BETH WHITSETT DAVIS PHARMD.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2011
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Last Update Date | 04/14/2011
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Provider Practice Location Address
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Address Line | 16100 HIGHWAY 72
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City | ROGERSVILLE
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State | AL
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Zip | 35652-8119
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Country | US
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Telephone | 256-247-6830
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Fax | 256-247-6833
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Provider Business Mailing Address
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Address Line | 139 MEADOW RIDGE LN
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City | ROGERSVILLE
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State | AL
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Zip | 35652-6354
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Country | US
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Telephone | 256-247-3191
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Fax |
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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 | 15498
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License Number State | AL
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