| NPI | 1649752163 |
|---|---|
| Other Name | DAVY CROCKETT DRUG (LTC) |
| Entity Type | Organization |
| Authorized Contact | JAMES JEFFREY MARTIN President 936-544-2275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: TX 04623) |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2018-08-31 |