Dave'S Supermarkets Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

01-1713000 Issued in OH

Legal business name

DAVE'S SUPERMARKETS INC

Doing business as

dave's pharmacy 14

Practice address

16820 Harvard Ave
Cleveland, OH 44128-2208

Phone

(216) 991-8648

Fax

(216) 991-8655

NPI assigned

Jun 25, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Joel M Wolfe, PHARMACIST

Title

Pharmacy Manager

Phone

(216) 361-0735

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• dave's pharmacy 14 Doing business as

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1760688030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16820 HARVARD AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44128",
            "telephone_number": "216-991-8648",
            "fax_number": "216-991-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16820 HARVARD AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441282208",
            "telephone_number": "216-991-8648",
            "fax_number": "216-991-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVE'S SUPERMARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "216-361-0735",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "01-1713000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2754327",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dave's pharmacy 14",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Ann Daunov, RN MSN ANP
• Michael Daunov, DO
• Augustine Dautey
• Pooja Rajesh Dave, MD/MPH
• Dave'S Supermarket Inc.
• Veronica Davenport Wilson, DECEMBER 10TH, 2020
• Holly Davenport
• Trinisa Davenport
• Tyraya Davenport
• Westine Davenport, INDEPENDENT PROVIDER

• Community/Retail Pharmacy in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.