Organization Active NPI

Davis Drugs LLC

  • Community/Retail Pharmacy
  • Attica, IN
National Provider Identifier
1902883994
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
60006316A Issued in IN
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

Updated by the provider on Feb 5, 2021

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2138094OtherPK
201111490AMedicaidIN

Other names 1

  • Davis Drugs Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Locations

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.

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.

Verify at the official NPI Registry.