Provider Demographics
NPI:1487860839
Name:BEY, DAVITA L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVITA
Middle Name:L
Last Name:BEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DAVITA
Other - Middle Name:L
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3750 LANKENAU RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-2817
Mailing Address - Country:US
Mailing Address - Phone:215-908-7211
Mailing Address - Fax:
Practice Address - Street 1:29 BALA AVE STE 114
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3206
Practice Address - Country:US
Practice Address - Phone:484-278-4308
Practice Address - Fax:866-840-0033
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003595183500000X
PARP440478183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist