Provider Demographics
NPI:1659682151
Name:DAVIS-DEAS, RITA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:
Last Name:DAVIS-DEAS
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 1:4306 ABELE CV
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-8063
Mailing Address - Country:US
Mailing Address - Phone:901-340-1353
Mailing Address - Fax:
Practice Address - Street 1:2471 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38108-3318
Practice Address - Country:US
Practice Address - Phone:901-454-1615
Practice Address - Fax:901-454-4908
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22113183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist