Healthcare Provider Details

I. General information

NPI: 1033411178
Provider Name (Legal Business Name): DAVID RANDALL DRAYER R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2010
Last Update Date: 04/16/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 E MAIN ST
POMEROY OH
45769-1161
US

IV. Provider business mailing address

71 SUNNYSIDE DR
ATHENS OH
45701-1921
US

V. Phone/Fax

Practice location:
  • Phone: 740-992-2955
  • Fax:
Mailing address:
  • Phone: 740-849-2768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03236382
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: