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General NPI Number Information
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NPI Number | 1003867227
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Entity Type | Organization
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Legal Business Name | RAY'S PHARMACY, INC.
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 09/05/2014
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Provider Practice Location Address
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Address Line | 1831 E BROAD ST 101
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City | MANSFIELD
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State | TX
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Zip | 76063-9170
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Country | US
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Telephone | 817-473-1145
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Fax | 817-473-6749
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Provider Business Mailing Address
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Address Line | 1831 E BROAD ST 207
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City | MANSFIELD
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State | TX
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Zip | 76063-9170
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Country | US
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Telephone | 817-473-1147
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Fax | 817-473-9555
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. ROBERT DANIEL RAY
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Credential | R.PH.
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Telephone | 817-473-1505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 01376
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License Number State | TX
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