Davis Pharmacy Inc – Community/Retail Pharmacy

Key facts

NPI: 1811960263
Entity type: Organization (NPI type 2)
Primary specialty: Community/Retail Pharmacy 3336C0003X
License: 100-0455 (SD)
Legal business name: DAVIS PHARMACY INC
Practice address: 5 W Cherry St
Vermillion, SD 57069-1107
Phone: (605) 624-4444
Fax: (605) 624-5975
NPI assigned: Feb 8, 2006
Organization subpart: No

Authorized official

Name: Matthew Lavin NPI 1477679298
Title: President
Phone: (605) 624-4444

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

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.

Davis Unit Dose Long Term Care Pharmacy · Vermillion, SD · NPI 1154506608

NPPES parent name

Corporate family (same tax ID) 1

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

Davis Unit Dose Long Term Care Pharmacy · Vermillion, SD · NPI 1154506608

NPD tax ID

Practitioners 1

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

Matthew Lavin, RPH Pharmacist · Vermillion, SD · NPI 1477679298

NPD Authorized official

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Supplier	Supplies	Medicare assignment
Davis Pharmacy 5 W Cherry St, Vermillion, SD 57069-1107 · (605) 624-4444	Nebulizer Drugs\|Blood Glucose Monitors/Supplies (Non-Mail Order)	Accepts assignment Participating since Jan 1, 2006

Medicare participation

Medicare fee-for-service enrollment: Enrolled (2 enrollments) in SD

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20100930090533	SD	DME Supplier - Pharmacy DME Supplier - Medical Supply Company DME Supplier - Medical Supply Company With Registered Pharmacist	3577682418	Practice locations: Vermillion, SD
O20160617001144	SD	Part B Supplier - Mass Immunization (Roster Biller Only)	3577682418	Practice locations: Vermillion, SD

National Provider Directory

Tax ID family: Davis Unit Dose (2 organizations share this tax ID)

Locations

5 W Cherry St
Vermillion, SD 57069
Phone (605) 624-4444

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacy	333600000X
Community/Retail Pharmacy	3336C0003X	100-0455	SD	Yes

Addresses

Primary practice location

5 W Cherry St
Vermillion, SD 57069-1107

Mailing address

5 W Cherry St
Vermillion, SD 57069-1107
Phone (605) 624-4444

Other identifiers

Identifier	Type	State	Issuer
8501470	Medicaid	SD
2093875	Other		PK

Other names

DAVIS PHARMACY Doing business as

Other providers in Vermillion, SD

All providers in Vermillion, SD · Community/Retail Pharmacy in South Dakota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.