Davis Brothers Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

SP0552508 Issued in WV

Legal business name

DAVIS BROTHERS PHARMACY INC

Doing business as

Davis Brothers Pharmacy - Chester

Practice address

559 Carolina Ave Ste B
Chester, WV 26034-1364

Phone

(304) 387-1741

Fax

(304) 387-1741

NPI assigned

Nov 10, 2016

Last updated

Dec 22, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey DavisNPI 1174958813

Title

President/Pharmacist

Phone

(304) 670-8107

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Davis Brothers Pharmacy - Chester Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Davis Brothers Pharmacy, Inc.

  dba Davis Brothers Pharmacy

  • Community/Retail Pharmacy
  • New Cumberland, WV
  • NPI 1154722064

  O20150106001759

  Same enrollment

Tax ID family

Davis Brothers Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Davis Brothers Pharmacy, Inc.

  dba Davis Brothers Pharmacy

  • Community/Retail Pharmacy
  • New Cumberland, WV
  • NPI 1154722064
  NPD tax ID

Locations

Practitioners 3

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.

• Jeffrey Paul Davis, PHARM.D.

  • Pharmacist
  • Wheeling, WV
  • NPI 1174958813
  NPD Authorized official
• Kristian Fuchs, PHARMD

  • Pharmacist
  • New Cumberland, WV
  • NPI 1144929993
  NPD (past)
• Joseph Michael Wenzowski, RPH

  • Pharmacist
  • Steubenville, OH
  • NPI 1316669427
  NPD (past)

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482364800000",
    "number": "1083156863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 CAROLINA AVE STE B",
            "city": "CHESTER",
            "state": "WV",
            "postal_code": "260341364",
            "telephone_number": "304-387-1741",
            "fax_number": "304-387-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 CAROLINA AVE STE B",
            "city": "CHESTER",
            "state": "WV",
            "postal_code": "260341364",
            "telephone_number": "304-387-1741",
            "fax_number": "304-387-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS BROTHERS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-10",
        "last_updated": "2016-12-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST",
        "authorized_official_telephone_number": "304-670-8107"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WV",
            "license": "SP0552508",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083156863",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2166220",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davis Brothers Pharmacy - Chester",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Chester, WV
• Providers in Chester, WV by specialty
• Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.