MEDICARE: DR. CHRISTIAN LANCE DAVIS PHARM.D., MHA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	12129	NC

General Provider Information

NPI Number	:	1215970272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIAN LANCE DAVIS PHARM.D., MHA

Provider Business Mailing Address
First Line	:	11500 NORTHLAKE DR
Second Line	:	SUITE 200
City	:	CINCINNATI
State	:	OH
Zip	:	45249-1650
Country	:	US
Telephone Number	:	513-247-4298
Fax Number	:

Provider Business Practice Location Address
First Line	:	11500 NORTHLAKE DR
Second Line	:	SUITE 200
City	:	CINCINNATI
State	:	OH
Zip	:	45249-1650
Country	:	US
Telephone Number	:	513-247-4298
Fax Number	:	513-247-4620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	07/22/2009

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