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General NPI Number Information
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NPI Number | 1356366207
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Entity Type | Organization
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Legal Business Name | HAYNES DAVIS INC
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 708 W SCHARBAUER DR
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City | MIDLAND
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State | TX
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Zip | 79705-8925
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Country | US
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Telephone | 432-682-2519
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Fax | 432-682-5857
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Provider Business Mailing Address
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Address Line | PO BOX 51388
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City | MIDLAND
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State | TX
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Zip | 79710-1388
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | JOHN DAVIS
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Credential | RPH
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Telephone | 432-682-2519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 22694
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License Number State | TX
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