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General NPI Number Information
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NPI Number | 1437284452
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Entity Type | Organization
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Legal Business Name | S. RAY JOHNSON
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 601 S. BLISS AVE
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City | DUMAS
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State | TX
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Zip | 79029-4434
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Country | US
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Telephone | 806-935-2333
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Fax | 806-935-7096
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Provider Business Mailing Address
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Address Line | 601 S. BLISS AVE
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City | DUMAS
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State | TX
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Zip | 79029-4434
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Country | US
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Telephone | 806-935-2333
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Fax | 806-935-7096
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Authorized Official
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Title or Position | PHARMACIST OWNER
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Name | S RAY JOHNSON
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Credential | RPH
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Telephone | 806-935-2333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 02472
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State | TX
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