NPIMap

Organization Active NPI

Davis Pharmacy Inc.

Doing business as Davis Pharmacy

  • Community/Retail Pharmacy
  • New Madrid, MO
National Provider Identifier
1063526036
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
003656 Issued in MO
Legal business name
DAVIS PHARMACY INC.
Doing business as
Davis Pharmacy
Practice address
415 Mott St
New Madrid, MO 63869-1955
Phone
(573) 748-5205
Fax
(573) 748-2838
NPI assigned
Aug 18, 2006
Last updated
Mar 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary Kay Davis
Title
Owner/President
Phone
(573) 748-5205

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 003656 MO Primary

Addresses

Primary practice location

415 Mott St
New Madrid, MO 63869-1955

Mailing address

415 Mott St
New Madrid, MO 63869-1955

Other identifiers 2

IdentifierTypeStateIssuer
2609040OtherNCPDP PROVIDER IDENTIFICATION NUMBER
600133805MedicaidMO

Other names 1

  • DAVIS PHARMACY Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269820800000",
    "number": "1063526036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MOTT ST",
            "city": "NEW MADRID",
            "state": "MO",
            "postal_code": "638691955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MOTT ST",
            "city": "NEW MADRID",
            "state": "MO",
            "postal_code": "638691955",
            "telephone_number": "573-748-5205",
            "fax_number": "573-748-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2010-03-29",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "573-748-5205"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "003656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2609040",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600133805",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DAVIS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Madrid, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.