Provider Demographics
NPI:1740557057
Name:DAVIDSON, APRIL (RPH)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:DAVIDSON
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 1:2508 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-3509
Mailing Address - Country:US
Mailing Address - Phone:712-328-2266
Mailing Address - Fax:712-328-9063
Practice Address - Street 1:2508 W BROADWAY
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-3509
Practice Address - Country:US
Practice Address - Phone:712-328-2266
Practice Address - Fax:712-328-9063
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist