Active NPI
Spencer Thomas Davila, RPH
- Pharmacist
- Spring Valley, NY
National Provider Identifier
1265617732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 042143
- Practice address
- 208 East Route 59
Spring Valley, NY 10977-2910 - Phone
- (845) 352-7865
- NPI assigned
- Jan 3, 2008
- Last updated
- Mar 29, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 042143 | NY | Primary |
Addresses
Primary practice location
208 East Route 59
Spring Valley, NY 10977-2910
Mailing address
19 Hereford LN
New City, NY 10956-6606
Phone (845) 323-4446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042143 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332979200000",
"number": "1265617732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 HEREFORD LN",
"city": "NEW CITY",
"state": "NY",
"postal_code": "109566606",
"telephone_number": "845-323-4446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 EAST ROUTE 59",
"city": "SPRING VALLEY",
"state": "NY",
"postal_code": "109772910",
"telephone_number": "845-352-7865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVILA",
"first_name": "SPENCER",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-03",
"last_updated": "2012-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "042143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Valley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.