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Contact Information

DAVY CROCKETT DRUG, INC.
107 S 4TH ST
CROCKETT, TX75835
 Phone: 936-544-2275
 Fax: 936-206-7696
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for DAVY CROCKETT DRUG, INC.

NPI # 1407944382
LBN Legal business name DAVY CROCKETT DRUG, INC.
Authorized official JAMES MARTIN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/10/2006
Last updated 07/14/2025 - About 11 months ago
Identifiers
TX License # 04623
TX License # 4623
TX Medicaid 141598
Other 4516893 OTHER ID NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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