Provider Demographics
NPI:1699877688
Name:DAVIS, ANNETTE M (RPH)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 CORBIN DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2590
Mailing Address - Country:US
Mailing Address - Phone:174-029-7194
Mailing Address - Fax:740-450-1625
Practice Address - Street 1:860 BETHESDA DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1800
Practice Address - Country:US
Practice Address - Phone:740-450-1620
Practice Address - Fax:740-450-1625
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-24074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist