E Davidson RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010812 Issued in MI

Legal business name

E DAVIDSON RX LLC

Practice address

4420 E Davison St
Detroit, MI 48212-1744

Phone

(313) 334-6711

Fax

(313) 334-6710

NPI assigned

Nov 2, 2017

Organization subpart

Yes

Parent organization

E DAVIDSON MANAGEMENT INCAs reported in NPPES

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

Authorized official

Name

Candice Tolf

Title

3Rd Party Coordinator

Phone

(313) 751-7979

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Knight Drugs - E Davidson Doing business as

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1366954067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6689 ORCHARD LAKE RD STE 168",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 E DAVISON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121744",
            "telephone_number": "313-334-6711",
            "fax_number": "313-334-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E DAVIDSON RX LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "E DAVIDSON MANAGEMENT INC",
        "enumeration_date": "2017-11-02",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "TOLF",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "3RD PARTY COORDINATOR",
        "authorized_official_telephone_number": "313-751-7979"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLEXSCRIPT",
            "identifier": "FSRX1950290",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knight Drugs - E Davidson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Malgorzata Dziadkowiec
• Patricia Dzieciolowski, MSW,CSW
• Elberta Dziobak, CNM
• John T Dziuba, MD
• E & G Medical Associates PC
• Lenricco E Williams
• Raven-Dunaj Eaddy, LLMSW
• Reginald J Eadie, M.D.
• Robert L Eagles
• Tina Ealey, LLC

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.