Provider Demographics
NPI:1942802798
Name:DAVIS, WHITNEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
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 1:190 JFK PLZ
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5015
Mailing Address - Country:US
Mailing Address - Phone:207-872-2182
Mailing Address - Fax:207-877-7568
Practice Address - Street 1:190 JFK PLZ
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5015
Practice Address - Country:US
Practice Address - Phone:207-872-2182
Practice Address - Fax:207-877-7568
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR6057183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist