Provider Demographics
NPI:1942846449
Name:W, DAVIS RX LLC
Entity Type:Organization
Organization Name:W, DAVIS RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIMFARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-703-5232
Mailing Address - Street 1:3421 W DAVIS ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1846
Mailing Address - Country:US
Mailing Address - Phone:936-703-5232
Mailing Address - Fax:936-703-5840
Practice Address - Street 1:3421 W DAVIS ST STE 200
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1846
Practice Address - Country:US
Practice Address - Phone:936-703-5232
Practice Address - Fax:936-703-5840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE