MEDICARE: DAVIDSON DRUGS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PH1405	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2006959	OTHER		PK

General Provider Information

NPI Number	:	1194868307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVIDSON DRUGS INC

Provider Business Mailing Address
First Line	:	5124 OCEAN BLVD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34242-1637
Country	:	US
Telephone Number	:	941-349-1111
Fax Number	:	941-312-0631

Provider Business Practice Location Address
First Line	:	5124 OCEAN BLVD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34242-1637
Country	:	US
Telephone Number	:	941-349-1111
Fax Number	:	941-312-0631

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	RICHARD DAVIDSON
Credential	:
Telephone Number	:	941-365-1515

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	02/20/2017

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Directions to “DAVIDSON DRUGS INC ” Practice Location

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