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General NPI Number Information
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NPI Number | 1801446380
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Entity Type | Organization
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Legal Business Name | DAVIDSON DRUG, LLC
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Dates
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Enumeration Date | 09/16/2019
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 1238A HIGHWAY 62 412
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City | HIGHLAND
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State | AR
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Zip | 72542-9468
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Country | US
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Telephone | 870-955-1022
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Fax |
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Provider Business Mailing Address
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Address Line | 489 ORR RD
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City | ASH FLAT
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State | AR
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Zip | 72513-9705
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Country | US
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Telephone | 870-955-1022
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Fax | 870-955-5052
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MR. KEN SEARCY DAVIDSON
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Credential | PD
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Telephone | 870-955-1022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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