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General NPI Number Information
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NPI Number | 1700103629
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Entity Type | Individual
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Provider Name | DENNIS RAY PRYOR PHARMD.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2010
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Last Update Date | 05/02/2010
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Provider Practice Location Address
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Address Line | 949 KENDALL DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-5801
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Country | US
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Telephone | 909-886-1461
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Fax | 909-881-0581
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Provider Business Mailing Address
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Address Line | 10657 GEMINI DR
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City | RIVERSIDE
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State | CA
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Zip | 92503-6044
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Country | US
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Telephone | 951-687-0703
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Fax |
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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 | RPH38948
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License Number State | CA
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