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NPI Code Detail

MEDICARE: ERIC DAVIS CPHT

MEDICARE:   ERIC  DAVIS  CPHT
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
1183700000XPharmacy Technician14559MT

General Provider Information

NPI Number : 1558796870
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC DAVIS CPHT
Provider Business Mailing Address
First Line : 2415 S CATLIN ST
Second Line :
City : MISSOULA
State : MT
Zip : 59801-7822
Country : US
Telephone Number : 406-549-0114
Fax Number :
Provider Business Practice Location Address
First Line : 2415 S CATLIN ST
Second Line :
City : MISSOULA
State : MT
Zip : 59801-7822
Country : US
Telephone Number : 406-549-0114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2013
Last Update Date : 09/05/2013

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Directions to “ ERIC DAVIS CPHT” Practice Location

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