Provider Demographics
NPI:1477120327
Name:DAVIS, WENDY (PHARMD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 TOWN FARM RD
Mailing Address - Street 2:
Mailing Address - City:PASCOAG
Mailing Address - State:RI
Mailing Address - Zip Code:02859-2412
Mailing Address - Country:US
Mailing Address - Phone:401-309-7094
Mailing Address - Fax:
Practice Address - Street 1:445 PUTNAM PIKE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-2430
Practice Address - Country:US
Practice Address - Phone:401-231-5320
Practice Address - Fax:401-231-8547
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH04442183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist