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NPI Code Detail

MEDICARE: DR. RITA DAVIS-DEAS PHARMD

MEDICARE: DR. RITA DAVIS-DEAS PHARMD
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
1183500000XPharmacist22113TN

General Provider Information

NPI Number : 1659682151
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RITA DAVIS-DEAS PHARMD
Provider Business Mailing Address
First Line : 4306 ABELE CV
Second Line :
City : OLIVE BRANCH
State : MS
Zip : 38654-8063
Country : US
Telephone Number : 901-340-1353
Fax Number :
Provider Business Practice Location Address
First Line : 2471 JACKSON AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38108-3318
Country : US
Telephone Number : 901-454-1615
Fax Number : 901-454-4908
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2010
Last Update Date : 06/29/2010

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