Provider Information for 1841488053
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HAYNES-DAVIS INC
Other Names:Doing Business As:SERVICE DRUG OF MIDLAND #1Organization Subpart: NO
NPI: 1841488053
Last Updated: 2009-04-13
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1841488053 | ||||||||||||||||
| Enumeration Date | 2007-10-12 | ||||||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Authorized Official Information | Name: JOHN DAVIS BSPHARM Title: OWNER Phone: 4326822519 | ||||||||||||||||
| Mailing Address | PO BOX 51940 MIDLAND, TX 79710-1940 United States Phone: | Fax: | ||||||||||||||||
| Primary Practice Address | 4416 BRIARWOOD AVE STE 100 MIDLAND, TX 79707-2615 United States Phone: 432-697-7378 | Fax:432-618-0776 | ||||||||||||||||
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