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General NPI Number Information
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NPI Number | 1760580765
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Entity Type | Organization
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Legal Business Name | G L DAVIS DRUG INC.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 109 WEST ST
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City | CALDWELL
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State | OH
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Zip | 43724-1359
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Country | US
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Telephone | 740-732-4503
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Fax |
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Provider Business Mailing Address
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Address Line | 109 WEST ST
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City | CALDWELL
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State | OH
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Zip | 43724-1359
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Country | US
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Telephone | 740-732-4503
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. GARY LEE DAVIS
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Credential | R.PH
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Telephone | 740-732-4503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 02-0693900
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License Number State | OH
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