Provider Demographics
NPI:1952063729
Name:DAVIS DRUGS
Entity Type:Organization
Organization Name:DAVIS DRUGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:228-222-4249
Mailing Address - Street 1:118 DAVIS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:PASS CHRISTIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39571-4504
Mailing Address - Country:US
Mailing Address - Phone:228-222-4249
Mailing Address - Fax:228-222-4364
Practice Address - Street 1:118 DAVIS AVE STE B
Practice Address - Street 2:
Practice Address - City:PASS CHRISTIAN
Practice Address - State:MS
Practice Address - Zip Code:39571-4504
Practice Address - Country:US
Practice Address - Phone:228-861-8203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-09
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy