Provider Demographics
NPI:1073505954
Name:DAVID'S PHARMACY, INC.
Entity Type:Organization
Organization Name:DAVID'S PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ORESTES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CARTAYA
Authorized Official - Suffix:
Authorized Official - Credentials:R PHARMACIST
Authorized Official - Phone:813-870-1967
Mailing Address - Street 1:2302 W MARTIN LUTHER KING
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6406
Mailing Address - Country:US
Mailing Address - Phone:813-870-1967
Mailing Address - Fax:813-870-3277
Practice Address - Street 1:2302 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6406
Practice Address - Country:US
Practice Address - Phone:813-870-1967
Practice Address - Fax:813-870-3277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH5077333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103272100Medicaid
FL1006837OtherNABP