Gary Lee Davis, RPH
Individual provider Active NPI Pharmacist · Caldwell, OH
NPI 1356446561 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1356446561
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03216592 (OH)
- Practice address
- 109 West Street
Caldwell, OH 43724-1359 - Phone
- (740) 732-4503
- Fax
- (740) 732-2272
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03216592 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| G L Davis Drug Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03216592 | OH | Yes |
Addresses
Primary practice location
109 West Street
Caldwell, OH 43724-1359
Mailing address
109 West Street
Caldwell, OH 43724-1359
Phone (740) 732-4503
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0872882 | Medicaid | OH |
Other providers in Caldwell, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.