Provider Demographics
NPI:1477651412
Name:RAVIRAY INC
Entity Type:Organization
Organization Name:RAVIRAY INC
Other - Org Name:FLOYD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:PINNAMARAJU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-745-2177
Mailing Address - Street 1:709 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLOYD
Mailing Address - State:VA
Mailing Address - Zip Code:24091-2621
Mailing Address - Country:US
Mailing Address - Phone:540-745-2177
Mailing Address - Fax:540-745-2269
Practice Address - Street 1:709 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FLOYD
Practice Address - State:VA
Practice Address - Zip Code:24091-2621
Practice Address - Country:US
Practice Address - Phone:540-745-2177
Practice Address - Fax:540-745-2269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
VA02010014283336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2132411OtherPK