Provider Demographics
NPI:1578686366
Name:DAVIS, MELINDA FOLMAR (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:FOLMAR
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7574 LAKERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-8504
Mailing Address - Country:US
Mailing Address - Phone:334-279-8284
Mailing Address - Fax:
Practice Address - Street 1:7946 VAUGHN RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-6625
Practice Address - Country:US
Practice Address - Phone:334-272-1515
Practice Address - Fax:334-272-1751
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist