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General NPI Number Information
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NPI Number | 1689288508
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Entity Type | Individual
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Provider Name | ERIC NICHOLAS DAVIS RPH
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Gender | Male
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 302 E EMMITT AVE
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City | WAVERLY
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State | OH
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Zip | 45690-1338
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Country | US
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Telephone | 740-370-8662
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Fax |
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Provider Business Mailing Address
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Address Line | 45 COLONY DR APT 202
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City | WHEELERSBURG
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State | OH
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Zip | 45694-8096
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Country | US
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Telephone | 740-370-8662
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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 | 03-2-19338
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License Number State | OH
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