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General NPI Number Information
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NPI Number | 1114168259
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Entity Type | Individual
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Provider Name | GAYNELL H SMITH-GRAY RPH
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Gender | Female
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Dates
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Enumeration Date | 03/19/2009
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 2812 E PARHAM RD
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City | RICHMOND
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State | VA
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Zip | 23228-2918
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Country | US
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Telephone | 804-264-6418
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Fax |
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Provider Business Mailing Address
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Address Line | 5 TAMERLANE DR
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City | STAFFORD
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State | VA
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Zip | 22554-7737
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Country | US
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Telephone | 540-657-9806
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Fax | 540-288-1996
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202006618
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License Number State | VA
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