Provider Demographics
NPI:1811073141
Name:MAYS-DUNAVANT DRUGS INC
Entity type:Organization
Organization Name:MAYS-DUNAVANT DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST CORPORATION PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DUNAVANT
Authorized Official - Suffix:JR
Authorized Official - Credentials:PD
Authorized Official - Phone:731-635-9191
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-0067
Mailing Address - Country:US
Mailing Address - Phone:731-635-9191
Mailing Address - Fax:731-636-9192
Practice Address - Street 1:111 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-1307
Practice Address - Country:US
Practice Address - Phone:731-635-9191
Practice Address - Fax:731-636-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-30
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000484332B00000X
TN00000010883336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3512429Medicaid
TN3512429Medicaid
TN0549790001Medicare NSC