Provider Demographics
NPI:1811259005
Name:ROWE DAVIS, DYAN M (RP)
Entity type:Individual
Prefix:
First Name:DYAN
Middle Name:M
Last Name:ROWE DAVIS
Suffix:
Gender:F
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 JENNY LYNN COURT
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239
Mailing Address - Country:US
Mailing Address - Phone:973-202-7258
Mailing Address - Fax:
Practice Address - Street 1:1804 GOLDENMILE HIGHWAY
Practice Address - Street 2:RITE AID PHARMACY #10955
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15239
Practice Address - Country:US
Practice Address - Phone:724-327-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02640800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist