Daves Supermarket Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

02-0748900 Issued in OH

Legal business name

DAVES SUPERMARKET INC

Practice address

3565 Ridge Rd
Cleveland, OH 44102-5443

Phone

(216) 961-2005

Fax

(216) 631-1544

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Dennis J Eller, RPH

Title

Pharmacy Manager

Phone

(216) 961-2005

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1801819792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3565 RIDGE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441025443",
            "telephone_number": "216-961-2005",
            "fax_number": "216-631-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3565 RIDGE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441025443",
            "telephone_number": "216-961-2005",
            "fax_number": "216-631-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVES SUPERMARKET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "ELLER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "216-961-2005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "02-0748900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Davenport Wilson, DECEMBER 10TH, 2020
• Holly Davenport
• Trinisa Davenport
• Tyraya Davenport
• Westine Davenport, INDEPENDENT PROVIDER
• Alexander Daves, D.O.
• Nitin Davessar, MD
• Timothy Charles Davian Jr.
• David P Agle MD Inc
• David Perse MD, LLC

• 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 Jun 18, 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.