Active NPI
Davis Drug Store Inc
- Durable Medical Equipment & Medical Supplies
- Highland, AR
National Provider Identifier
1598060659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- DAVIS DRUG STORE INC
- Practice address
- 1645 Highway 62 412
Highland, AR 72542-9540 - Phone
- (870) 856-3080
- Fax
- (870) 856-4165
- NPI assigned
- Jan 21, 2011
- Last updated
- Mar 16, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Andrea D Davis
- Title
- President
- Phone
- (870) 856-3080
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | Primary |
Addresses
Primary practice location
1645 Highway 62 412
Highland, AR 72542-9540
Mailing address
PO Box 428
Ash Flat, AR 72513-0428
Phone (870) 856-3080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110114000301 | AR | DME Supplier - Pharmacy | 0345439832 | Practice locations: Highland, AR |
| O20190425000166 | AR | Part B Supplier - Pharmacy | 0345439832 | Practice locations: Highland, AR |
National Provider Directory
National Provider Directory- Tax ID family
- Davis Drug Store Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295568000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1300233600000",
"number": "1598060659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 428",
"city": "ASH FLAT",
"state": "AR",
"postal_code": "725130428",
"telephone_number": "870-856-3080",
"fax_number": "870-856-4165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1645 HIGHWAY 62 412",
"city": "HIGHLAND",
"state": "AR",
"postal_code": "725429540",
"telephone_number": "870-856-3080",
"fax_number": "870-856-4165"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAVIS DRUG STORE INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-01-21",
"last_updated": "2011-03-16",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "ANDREA",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "870-856-3080"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.