Organization
HAYNES-DAVIS INC
Active
Other names
SERVICE DRUG OF MIDLAND #1
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DAVIS BSPHARM (OWNER)
(432) 682-2519
Entity
Organization
Contact information
Practice address
4416 BRIARWOOD AVE, STE 100, MIDLAND, TX 79707-2615
(432) 697-7378
(432) 618-0776
Mailing address
PO BOX 51940, MIDLAND, TX 79710-1940
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25760
TX
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4546187
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/12/2007
Last updated
04/13/2009
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