Healthcare Provider Details

I. General information

NPI: 1184600280
Provider Name (Legal Business Name): BRAY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 07/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

662 E MAIN ST
FRANKFORT KY
40601-2338
US

IV. Provider business mailing address

662 E MAIN ST
FRANKFORT KY
40601-2338
US

V. Phone/Fax

Practice location:
  • Phone: 502-223-2827
  • Fax: 502-227-2026
Mailing address:
  • Phone: 502-223-2827
  • Fax: 502-227-2026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberP01908
License Number StateKY

VIII. Authorized Official

Name: AARON MCINTOSH
Title or Position: OWNER
Credential:
Phone: 502-223-2827