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NPI Code Detail

MEDICARE: LESLIE RAY

MEDICARE: LESLIE RAY
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
1183500000XPharmacist26020281AIN

General Provider Information

NPI Number : 1972948909
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE RAY
Provider Business Mailing Address
First Line : 5960 CASTLEWAY WEST DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-1977
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5960 CASTLEWAY WEST DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-1977
Country : US
Telephone Number : 317-579-8144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2013
Last Update Date : 05/03/2013

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Directions to “ LESLIE RAY ” Practice Location

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