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General NPI Number Information
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NPI Number | 1841488053
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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 | 10/12/2007
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Last Update Date | 04/13/2009
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Provider Practice Location Address
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Address Line | 4416 BRIARWOOD AVE STE 100
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City | MIDLAND
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State | TX
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Zip | 79707-2615
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Country | US
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Telephone | 432-697-7378
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Fax | 432-618-0776
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Provider Business Mailing Address
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Address Line | PO BOX 51940
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City | MIDLAND
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State | TX
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Zip | 79710-1940
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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 | OWNER
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Name | JOHN DAVIS
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Credential | BSPHARM
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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 | 25760
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License Number State | TX
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