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General NPI Number Information
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NPI Number | 1669455093
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Entity Type | Organization
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Legal Business Name | DAVCO DRUG CO INC
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 69 MAIN STREET
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City | COPAKE
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State | NY
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Zip | 12516
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Country | US
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Telephone | 518-329-4671
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | COPAKE
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State | NY
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Zip | 12516-0010
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Country | US
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Telephone | 518-329-4671
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HUGH WALTER DAVIS
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Credential | RPH
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Telephone | 518-329-4671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 019282
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License Number State | NY
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