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NPI Code Detail

MEDICARE: ROBYN GRAY

MEDICARE: ROBYN GRAY
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
1183500000XPharmacist16172LA

General Provider Information

NPI Number : 1811306053
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBYN GRAY
Provider Business Mailing Address
First Line : 4810 LAPALCO BLVD
Second Line :
City : MARRERO
State : LA
Zip : 70072-4382
Country : US
Telephone Number : 504-341-1363
Fax Number :
Provider Business Practice Location Address
First Line : 4810 LAPALCO BLVD
Second Line :
City : MARRERO
State : LA
Zip : 70072-4382
Country : US
Telephone Number : 504-341-1363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2014
Last Update Date : 08/12/2014

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Directions to “ ROBYN GRAY ” Practice Location

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