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NPI Code Detail

MEDICARE: DR. MATTHEW WILLIAM RAY PHARM.D.

MEDICARE: DR. MATTHEW WILLIAM RAY PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist10604OR

General Provider Information

NPI Number : 1578784914
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW WILLIAM RAY PHARM.D.
Provider Business Mailing Address
First Line : 2011 E LAKE MEAD BLVD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7135
Country : US
Telephone Number : 702-219-8732
Fax Number : 401-652-1456
Provider Business Practice Location Address
First Line : 2011 E LAKE MEAD BLVD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7135
Country : US
Telephone Number : 702-219-8732
Fax Number : 401-652-1456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 11/30/2012

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