Healthcare Provider Details
I. General information
NPI: 1689615353
Provider Name (Legal Business Name): RAY'S PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
318 MAIN ST
QUINTER KS
67752-9526
US
IV. Provider business mailing address
318 MAIN ST PO BOX 428
QUINTER KS
67752-9526
US
V. Phone/Fax
- Phone: 785-754-3312
- Fax: 785-754-3844
- Phone: 785-754-3312
- Fax: 785-754-3844
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 2-08129 |
| License Number State | KS |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
DORIS
K
TEBOW
Title or Position: SEC/TREASURER
Credential:
Phone: 785-754-3312