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NPI Code Detail

MEDICARE: DR. JOHNNY RAY CAPPS RPH

MEDICARE:  DR. JOHNNY RAY CAPPS  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist9078SC

General Provider Information

NPI Number : 1770845034
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHNNY RAY CAPPS RPH
Provider Business Mailing Address
First Line : 3320 4TH AVE STE F
Second Line :
City : CONWAY
State : SC
Zip : 29527-6057
Country : US
Telephone Number : 843-248-6550
Fax Number : 843-248-6553
Provider Business Practice Location Address
First Line : 3320 4TH AVE STE F
Second Line :
City : CONWAY
State : SC
Zip : 29527-6057
Country : US
Telephone Number : 843-248-6550
Fax Number : 843-248-6553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2012
Last Update Date : 06/13/2012

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Directions to “ DR. JOHNNY RAY CAPPS RPH” Practice Location

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