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General NPI Number Information
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NPI Number | 1952063729
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Entity Type | Organization
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Legal Business Name | DAVIS DRUGS
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Dates
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Enumeration Date | 10/09/2021
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 118 DAVIS AVE STE B
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City | PASS CHRISTIAN
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State | MS
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Zip | 39571-4504
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Country | US
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Telephone | 228-861-8203
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Fax |
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Provider Business Mailing Address
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Address Line | 118 DAVIS AVE STE B
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City | PASS CHRISTIAN
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State | MS
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Zip | 39571-4504
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Country | US
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Telephone | 228-222-4249
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Fax | 228-222-4364
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Authorized Official
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Title or Position | PHARMACIST
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Name | ALICIA PUCKETT
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Credential | PHARM D
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Telephone | 228-222-4249
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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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