Provider Demographics
NPI:1073547436
Name:DAVIS, JAMES DONALD JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DONALD
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:RPH
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Mailing Address - Street 1:6028 S NC 16 HWY
Mailing Address - Street 2:
Mailing Address - City:MAIDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28650-8114
Mailing Address - Country:US
Mailing Address - Phone:704-489-2223
Mailing Address - Fax:704-489-2263
Practice Address - Street 1:3634 NORTH HWY 16
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037
Practice Address - Country:US
Practice Address - Phone:704-489-2223
Practice Address - Fax:704-489-2263
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC7430183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7430OtherSTATE PHARMACY PERMIT