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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