Healthcare Provider Details

I. General information

NPI: 1215941216
Provider Name (Legal Business Name): C & S KRAY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 12/18/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 CHERRY DR
HERSHEY PA
17033-2099
US

IV. Provider business mailing address

731 CHERRY DR
HERSHEY PA
17033-2099
US

V. Phone/Fax

Practice location:
  • Phone: 717-534-1300
  • Fax: 717-534-1707
Mailing address:
  • Phone: 717-534-1300
  • Fax: 717-534-1707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP414564L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0014767300002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MR. CHARLES KRAY
Title or Position: OWNER
Credential: RPH
Phone: 717-534-1300