Organization
HAYNES DAVIS INC
Active
Other names
SERVICE DRUG OF MIDLAND
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DAVIS RPH (PIC)
(432) 682-2519
Entity
Organization
Contact information
Practice address
708 W SCHARBAUER DR, MIDLAND, TX 79705-8925
(432) 682-2519
(432) 682-5857
Mailing address
PO BOX 51388, MIDLAND, TX 79710-1388
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
22694
TX
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4527101
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/13/2006
Last updated
07/06/2011
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