MEDICARE: MR. RICHARD HOWARD GRAY 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
1	183500000X	Pharmacist	6193	NC

General Provider Information

NPI Number	:	1891083226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD HOWARD GRAY RPH

Provider Business Mailing Address
First Line	:	1316 JOHN SMALL AVE
Second Line	:
City	:	WASHINGTON
State	:	NC
Zip	:	27889
Country	:	US
Telephone Number	:	252-946-1818
Fax Number	:	252-975-5785

Provider Business Practice Location Address
First Line	:	1316 JOHN SMALL AVE
Second Line	:
City	:	WASHINGTON
State	:	NC
Zip	:	27889-3843
Country	:	US
Telephone Number	:	252-946-1818
Fax Number	:	252-975-5785

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2011
Last Update Date	:	07/19/2011

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