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

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Ma Davis Enterprises LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1454269MedicaidTN
2089282OtherPK

Other names

  • Newbern Drug Healthmart Doing business as

Other providers in Newbern, TN

All providers in Newbern, TN · Durable Medical Equipment & Medical Supplies in Tennessee

Sources for this page

Verify at the official NPI Registry.