Ma Davis Enterprises, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MA DAVIS ENTERPRISES, LLC

Doing business as

Newbern Drug Healthmart

Practice address

625 W Main St.
Suite a.
Newbern, TN 38059

Phone

(731) 627-9573

Fax

(731) 627-3051

NPI assigned

Jun 12, 2018

Last updated

Jun 12, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

MA DAVIS ENTERPRISES, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Mark Anthony Davis, PHARM DNPI 1861082661

Title

Owner

Phone

(731) 589-0206

Specialties & licenses 1

Addresses

Other names 1

• Newbern Drug Healthmart Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

Tax ID family

Ma Davis Enterprises LLC2 organizations share this tax ID, including this one

Part of

Ma Davis Enterprises LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ma Davis Enterprises, LLC

  dba Newbern Drug Healthmart

  • Durable Medical Equipment & Medical Supplies
  • Newbern, TN
  • NPI 1760428254
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Ma Davis Enterprises, LLC

  dba Newbern Drug Healthmart

  • Durable Medical Equipment & Medical Supplies
  • Newbern, TN
  • NPI 1760428254
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Anthony Davis

  • Pharmacist
  • Newbern, TN
  • NPI 1861082661
  NPD Authorized official

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528761600000",
    "number": "1083107205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W MAIN ST",
            "address_2": "SUITE A",
            "city": "NEWBERN",
            "state": "TN",
            "postal_code": "38059",
            "telephone_number": "731-627-9573",
            "fax_number": "731-627-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W MAIN ST.",
            "address_2": "SUITE A.",
            "city": "NEWBERN",
            "state": "TN",
            "postal_code": "38059",
            "telephone_number": "731-627-9573",
            "fax_number": "731-627-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MA DAVIS ENTERPRISES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MA DAVIS ENTERPRISES, LLC",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-589-0206",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newbern Drug Healthmart",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Newbern Drug Healthmart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tammy Holcomb, NP
• Lisa Castellaw Hunt, FNP APN
• Patricia B. Keller, DPH
• Jane S Lamb, PHARM. D
• William W. Lents II, D.D.S.
• Ma Davis Enterprises, LLC (Newbern Drug Healthmart)
• Main Street Family Pharmacy LLC
• Main Street Family Pharmacy, LLC
• Beverly D McCann, FNP
• Sara Ellen Moody, LCSW

• Durable Medical Equipment & Medical Supplies in Newbern, TN
• Providers in Newbern, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.