Provider Demographics
NPI:1568546703
Name:GOAD & DAVIS INC
Entity Type:Organization
Organization Name:GOAD & DAVIS INC
Other - Org Name:STARLING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:GOAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:276-632-6222
Mailing Address - Street 1:1312 MEMORIAL BLVD S
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-4809
Mailing Address - Country:US
Mailing Address - Phone:276-632-6222
Mailing Address - Fax:276-632-3294
Practice Address - Street 1:1312 MEMORIAL BLVD S
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-4809
Practice Address - Country:US
Practice Address - Phone:276-632-6222
Practice Address - Fax:276-632-3294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201000774332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010264596Medicaid
VA5611810001Medicare NSC
VA5611810001Medicare PIN