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General NPI Number Information
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NPI Number | 1871060475
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Entity Type | Organization
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Legal Business Name | DAVIS DRUG STORE INC
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Dates
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Enumeration Date | 11/01/2018
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 1243 HIGHWAY 62 412
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City | HIGHLAND
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State | AR
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Zip | 72542-9469
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Country | US
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Telephone | 870-856-3080
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Fax | 870-856-4165
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Provider Business Mailing Address
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Address Line | 1243 HIGHWAY 62 412
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City | HIGHLAND
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State | AR
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Zip | 72542-9469
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Country | US
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Telephone | 870-856-3080
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Fax | 870-856-4165
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | ANDREA DAVIS
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Credential | PHARMD
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Telephone | 870-856-3080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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