Organization
DAVIS DRUG
Active
Other names
Davis Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DWAIN WILKERSON (PRESIDENT/PHARMACIST)
(757) 651-9440
Entity
Organization
Contact information
Practice address
2100 EXECUTIVE DR, HAMPTON, VA 23666-2402
(757) 745-7440
(757) 745-7441
Mailing address
2100 EXECUTIVE DR, HAMPTON, VA 23666-2402
(757) 745-7440
(757) 745-7441
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201004461
VA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2135385
PK
—
Enumeration date
02/08/2012
Last updated
01/05/2016
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