Provider Demographics
NPI:1285986943
Name:DAVIS, SAMANTHA MORRIS (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:MORRIS
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:SAMANTHA
Other - Middle Name:L
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:124 WILLIAMS CT
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-1466
Mailing Address - Country:US
Mailing Address - Phone:601-394-7590
Mailing Address - Fax:
Practice Address - Street 1:124 WILLIAMS CT
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-1466
Practice Address - Country:US
Practice Address - Phone:601-394-7590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17122183500000X
MSE12693183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist