Organization
MA DAVIS ENTERPRISES, LLC
Active
Other names
Newbern Drug Healthmart
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ANTHONY DAVIS PHARM D. (OWNER)
(731) 589-0206
Entity
Organization
Contact information
Practice address
625 W MAIN ST., SUITE A, NEWBERN, TN 38059
(731) 627-9573
(731) 627-3051
Mailing address
625 W. MAIN ST., SUITE A, NEWBERN, TN 38059
(731) 627-9573
(731) 627-3051
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TN
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
439
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454269
—
TN
01
—
2089282
PK
—
Enumeration date
06/21/2006
Last updated
03/23/2018
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