Provider Demographics
NPI:1326293341
Name:RAY, ROBERT REGINALD (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:REGINALD
Last Name:RAY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 FLANNERY PL
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-8312
Mailing Address - Country:US
Mailing Address - Phone:843-416-8125
Mailing Address - Fax:843-416-8125
Practice Address - Street 1:3725 RIVERS AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7038
Practice Address - Country:US
Practice Address - Phone:843-745-8630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist