Active NPI
Davis Drugs LLC
- Community/Retail Pharmacy
- Attica, IN
National Provider Identifier
1902883994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 60006316A
- Legal business name
- DAVIS DRUGS LLC
- Practice address
- 300 S Perry St
Attica, IN 47918-1442 - Phone
- (765) 762-3287
- Fax
- (765) 762-0021
- NPI assigned
- Dec 29, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Leslie Davis, DOCTOR OF PHARM
- Title
- Pharmacist
- Phone
- (765) 762-3287
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 60006316A | IN | Primary |
Addresses
Primary practice location
300 S Perry St
Attica, IN 47918-1442
Mailing address
300 S Perry St
Attica, IN 47918-1442
Phone (765) 762-3287
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2138094 | Other | PK | |
| 201111490A | Medicaid | IN |
Other names 1
- Davis Drugs
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130107000120 | IN | Part B Supplier - Mass Immunization (Roster Biller Only) | 2769635556 | Practice locations: Attica, IN |
| O20130718000443 | IN | DME Supplier - Pharmacy | 2769635556 | Practice locations: Attica, IN |
National Provider Directory
National Provider DirectoryLocations
300 S Perry St
Attica, IN 47918
Phone (765) 762-3287
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Attica, IN
- NPI 1235944232
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135814400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1612483200000",
"number": "1902883994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 S PERRY ST",
"city": "ATTICA",
"state": "IN",
"postal_code": "479181442",
"telephone_number": "765-762-3287",
"fax_number": "765-762-0021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 S PERRY ST",
"city": "ATTICA",
"state": "IN",
"postal_code": "479181442",
"telephone_number": "765-762-3287",
"fax_number": "765-762-0021"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAVIS DRUGS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-29",
"last_updated": "2021-02-05",
"certification_date": "2021-02-05",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "LESLIE",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "765-762-3287",
"authorized_official_credential": "DOCTOR OF PHARM"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IN",
"license": "60006316A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2138094",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201111490A",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Davis Drugs",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Attica, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.