NPIMap

Organization Active NPI

G L Davis Drug Inc.

  • Pharmacotherapy Pharmacist
  • Caldwell, OH
National Provider Identifier
1760580765
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
02-0693900 Issued in OH
Legal business name
G L DAVIS DRUG INC.
Practice address
109 West St
Caldwell, OH 43724-1359
Phone
(740) 732-4503
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Authorized official

Name
Mr. Gary Lee Davis, R.PHNPI 1356446561
Title
Owner
Phone
(740) 732-4503

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 1835P1200X 02-0693900 OH Primary

Addresses

Primary practice location

109 West St
Caldwell, OH 43724-1359

Mailing address

109 West St
Caldwell, OH 43724-1359
Phone (740) 732-4503

Other identifiers 1

IdentifierTypeStateIssuer
0872882MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070103000141 OH Part B Supplier - Mass Immunization (Roster Biller Only) 5799785499 Practice locations: Caldwell, OH
O20100930013099 OH DME Supplier - PharmacyDME Supplier - Orthotic PersonnelDME Supplier - Oxygen & Equipment 5799785499 Practice locations: Caldwell, OH

National Provider Directory

National Provider Directory
Tax ID family
G L Davis Drug Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

109 West St
Caldwell, OH 43724
Phone (740) 525-4485

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396915200000",
    "number": "1760580765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WEST ST",
            "city": "CALDWELL",
            "state": "OH",
            "postal_code": "437241359",
            "telephone_number": "740-732-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WEST ST",
            "city": "CALDWELL",
            "state": "OH",
            "postal_code": "437241359",
            "telephone_number": "740-732-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G L DAVIS DRUG INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-04-08",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-732-4503",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "OH",
            "license": "02-0693900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0872882",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.