Provider Demographics
NPI:1467611749
Name:DAVIS, ROBIN RAY (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:RAY
Last Name:DAVIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 EAST SECOND STREET
Mailing Address - Street 2:PO BOX 147
Mailing Address - City:KENLY
Mailing Address - State:NC
Mailing Address - Zip Code:27542
Mailing Address - Country:US
Mailing Address - Phone:919-284-4106
Mailing Address - Fax:919-284-2717
Practice Address - Street 1:104 EAST SECOND STREET
Practice Address - Street 2:
Practice Address - City:KENLY
Practice Address - State:NC
Practice Address - Zip Code:27542-0147
Practice Address - Country:US
Practice Address - Phone:919-284-4106
Practice Address - Fax:919-284-2717
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10063183500000X, 1835G0303X, 1835P0018X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy