Provider Demographics
NPI:1336282383
Name:DAVIDSON DRUGS INC
Entity Type:Organization
Organization Name:DAVIDSON DRUGS INC
Other - Org Name:DAVIDSON DRUGS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-365-1515
Mailing Address - Street 1:1281 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2200
Mailing Address - Country:US
Mailing Address - Phone:941-365-9116
Mailing Address - Fax:941-955-3428
Practice Address - Street 1:1281 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2200
Practice Address - Country:US
Practice Address - Phone:941-365-9116
Practice Address - Fax:941-955-3428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH78053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2006220OtherPK
FL101846900Medicaid