Ma Davis Enterprises, LLC
Organization Active NPI Durable Medical Equipment & Medical Supplies · Newbern, TN
NPI 1760428254 · NPPES record last updated Mar 23, 2018
Key facts
- NPI
- 1760428254
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- MA DAVIS ENTERPRISES, LLC
- Practice address
- 625 W Main St.
Suite a
Newbern, TN 38059 - Phone
- (731) 627-9573
- Fax
- (731) 627-3051
- NPI assigned
- Jun 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Mark Anthony Davis, PHARM D.
- Title
- Owner
- Phone
- (731) 589-0206
Subparts reporting this organization as parent 1
Corporate family (same tax ID) 1
Practitioners 1
National Provider Directory
- Tax ID family
- Ma Davis Enterprises LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | TN | Yes | |
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 439 | TN |
Addresses
Primary practice location
625 W Main St.
Suite a
Newbern, TN 38059
Mailing address
625 W. Main St.
Suite a
Newbern, TN 38059
Phone (731) 627-9573
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1454269 | Medicaid | TN | |
| 2089282 | Other | PK |
Other names
- Newbern Drug Healthmart
Other providers in Newbern, TN
- Lisa Castellaw Hunt
- Patricia B. Keller
- Jane S Lamb
- William W. Lents II
- Ma Davis Enterprises, LLC
- Main Street Family Pharmacy LLC
- Main Street Family Pharmacy, LLC
- Beverly D McCann
- Sara Ellen Moody
- Clint Edward Myers
All providers in Newbern, TN · Durable Medical Equipment & Medical Supplies in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.