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Organization
DAVY CROCKETT DRUG, INC.
Active
Organization
DAVY CROCKETT DRUG, INC.
Active
Other names
Davy Crockett Drug (LTC)
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES JEFFREY MARTIN RPH (PRESIDENT)
(936) 544-2275
Entity
Organization
Contact information
Practice address
107 S 4TH ST, CROCKETT, TX 75835-2024
(936) 544-2275
(936) 206-7696
Mailing address
107 S 4TH ST, CROCKETT, TX 75835-2024
(936) 544-2275
(936) 206-7696
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
04623
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141598
—
TX
Enumeration date
08/31/2018
Last updated
09/05/2025
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