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General NPI Number Information
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NPI Number | 1699850628
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Entity Type | Organization
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Legal Business Name | DAVIS CITY PHARMACY,INC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 111 TRINITY ST
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City | WEATHERFORD
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State | TX
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Zip | 76086-3358
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Country | US
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Telephone | 817-594-3851
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Fax | 817-596-8857
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Provider Business Mailing Address
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Address Line | PO BOX 640
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City | WEATHERFORD
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State | TX
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Zip | 76086-0640
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Country | US
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Telephone | 817-594-3851
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Fax | 817-596-8857
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRANDI CHANE
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Credential |
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Telephone | 817-594-3851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 00379
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License Number State | TX
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Taxonomy #2
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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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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