Patricia Davis

Individual provider Active NPI Pharmacist · Halifax, MA

NPI 1225638802 · NPPES record last updated Oct 31, 2020

Key facts

NPI
1225638802
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PH20517 (MA)
Practice address
295 Plymouth St
Halifax, MA 02338-1340
Phone
(781) 294-7001
Fax
(781) 294-1433
NPI assigned
Oct 31, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PH20517MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP Past
since Nov 8, 2020
Accepting new patients
Wal-Mart Stores East, LP Past
since Nov 8, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH20517 MA Yes

Addresses

Primary practice location

295 Plymouth St
Halifax, MA 02338-1340

Mailing address

449 Elm St
Kingston, MA 02364-1805
Phone (781) 690-3483

Other providers in Halifax, MA

All providers in Halifax, MA · Pharmacist in Massachusetts

Sources for this page

Verify at the official NPI Registry.