Organization
DAVY CROCKETT DRUG, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES J MARTIN RPH (PRESIDENT)
(936) 544-2275
Entity
Organization
Contact information
Practice address
107 S 4TH ST, CROCKETT, TX 75835
(936) 544-2275
(936) 206-7696
Mailing address
107 S 4TH ST, CROCKETT, TX 75835-2024
(936) 544-2275
(936) 544-3103
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
04623
TX
3336L0003X
Long Term Care Pharmacy
4623
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141598
—
TX
01
—
4516893
OTHER ID NUMBER
—
Enumeration date
10/10/2006
Last updated
07/14/2025
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