Provider Demographics
NPI:1730740242
Name:COVEY, DARCY (RPH)
Entity type:Individual
Prefix:MR
First Name:DARCY
Middle Name:
Last Name:COVEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:DARCY
Other - Middle Name:
Other - Last Name:COVEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:PO BOX 4278
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95352-4278
Mailing Address - Country:US
Mailing Address - Phone:209-577-1600
Mailing Address - Fax:
Practice Address - Street 1:1157 N WILLOW AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-4408
Practice Address - Country:US
Practice Address - Phone:559-297-0174
Practice Address - Fax:559-297-0212
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist