Organization
DAVIS PHARMACY INC.
Active
Other names
DAVIS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KAY DAVIS (OWNER/PRESIDENT)
(573) 748-5205
Entity
Organization
Contact information
Practice address
415 MOTT ST, NEW MADRID, MO 63869-1955
(573) 748-5205
(573) 748-2838
Mailing address
415 MOTT ST, NEW MADRID, MO 63869-1955
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
003656
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2609040
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
600133805
—
MO
Enumeration date
08/18/2006
Last updated
03/29/2010
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