Dr. Charles L Davenport Jr.
Pharmacist in Mableton, GA. Individual provider (NPI-1).
NPI number1104038686
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1104038686
- Entity type
- Individual (NPI-1)
- Name
- Dr. Charles L Davenport Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 4, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | ga017346 | GA | Yes |
Practice location
558 Ivey Way S.E.Mableton, GA 30126
Phone 678-575-8701
Mailing address
558 Ivey Way S.E.Mableton, GA 30126
Phone 678-575-8701
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All 30 Pharmacist providers in Mableton · All 422 providers in Mableton
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