Provider Demographics
NPI:1124020482
Name:BRAY, BRYAN KEITH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:KEITH
Last Name:BRAY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7008 OLD GREENSBORO RD
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-7429
Mailing Address - Country:US
Mailing Address - Phone:336-202-6599
Mailing Address - Fax:336-763-7352
Practice Address - Street 1:2006 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5634
Practice Address - Country:US
Practice Address - Phone:336-763-6968
Practice Address - Fax:336-763-7352
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7000071835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist