Provider Demographics
NPI:1780316075
Name:DAVIS, CODY PATRICK (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CODY
Middle Name:PATRICK
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1681 VALLEY AVE APT D
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1222
Mailing Address - Country:US
Mailing Address - Phone:912-856-2390
Mailing Address - Fax:
Practice Address - Street 1:2201 TYLER RD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-1705
Practice Address - Country:US
Practice Address - Phone:205-823-1832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist