Provider Demographics
NPI:1649649914
Name:DAVIS, BEATINA KING (PHARMD)
Entity type:Individual
Prefix:
First Name:BEATINA
Middle Name:KING
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 1:134 COURTRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237-1606
Mailing Address - Country:US
Mailing Address - Phone:731-587-3818
Mailing Address - Fax:731-588-0839
Practice Address - Street 1:134 COURTRIGHT RD
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-1606
Practice Address - Country:US
Practice Address - Phone:731-587-3818
Practice Address - Fax:731-588-0839
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist