William Allan Davis, D.PH.

Individual provider Active NPI Pharmacist · McMinnville, TN

NPI 1306135207 · NPPES record last updated Mar 31, 2011

Key facts

NPI
1306135207
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
C-5332 (TN)
Practice address
1410 Sparta St
McMinnville, TN 37110-1313
Phone
(931) 473-0788
Fax
(931) 506-2442
NPI assigned
Mar 31, 2011
Sex
Male
Sole proprietor
No

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
C-5332TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I Past Accepting new patients
Kroger Limited Partnership I Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X C-5332 TN Yes

Addresses

Primary practice location

1410 Sparta St
McMinnville, TN 37110-1313

Mailing address

1410 Sparta St
McMinnville, TN 37110-1313
Phone (931) 473-0788

Other providers in McMinnville, TN

All providers in McMinnville, TN · Pharmacist in Tennessee

Sources for this page

Verify at the official NPI Registry.