Davy Crockett Drug, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

04623 Issued in TX

Legal business name

DAVY CROCKETT DRUG, INC.

Practice address

107 S 4TH St
Crockett, TX 75835

Phone

(936) 544-2275

Fax

(936) 206-7696

NPI assigned

Oct 10, 2006

Last updated

Jul 14, 2025By 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

James J Martin, RPHNPI 1467013870

Title

President

Phone

(936) 544-2275

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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.

• James Jeffrey Martin, R.PH.

  • Pharmacist
  • Crockett, TX
  • NPI 1467013870
  NPD Authorized official

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1407944382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S 4TH ST",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758352024",
            "telephone_number": "936-544-2275",
            "fax_number": "936-544-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S 4TH ST",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "75835",
            "telephone_number": "936-544-2275",
            "fax_number": "936-206-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVY CROCKETT DRUG, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-544-2275",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "04623",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TX",
            "license": "4623",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141598",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4516893",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel M Gold MD PA
• Davis Medical Transportation
• Gabrielle Nicole Davis
• Rosa Lee Davis, M.ED., LPC
• Shemira Davis, QMHP-CS
• Davy Crockett Drug, Inc.
• Carol S Dawson, LCSW
• DCD Equipment, Inc (Davy Crockett Drug Clinical Services)
• East Texas Medical Center (ETMC Crockett Family Medical Center RHC)
• East Texas Medical Center Crockett (ETMC Crockett)

• Community/Retail Pharmacy in Crockett, TX
• Providers in Crockett, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.