Provider Demographics
NPI:1366589285
Name:DAVID'S PHARMACY INC
Entity type:Organization
Organization Name:DAVID'S PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLVARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:706-327-8967
Mailing Address - Street 1:1005 TALBOTTON RD
Mailing Address - Street 2:STE A
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8757
Mailing Address - Country:US
Mailing Address - Phone:706-327-8967
Mailing Address - Fax:706-576-5176
Practice Address - Street 1:1005 TALBOTTON RD
Practice Address - Street 2:STE A
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8757
Practice Address - Country:US
Practice Address - Phone:706-327-8967
Practice Address - Fax:706-576-5176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0049273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0303840001Medicare ID - Type Unspecified