Provider Demographics
NPI:1487848792
Name:RAY, SABRINA MARIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:MARIE
Last Name:RAY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:WAR
Mailing Address - State:WV
Mailing Address - Zip Code:24892-0697
Mailing Address - Country:US
Mailing Address - Phone:304-875-2330
Mailing Address - Fax:304-875-2332
Practice Address - Street 1:11880 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAR
Practice Address - State:WV
Practice Address - Zip Code:24892
Practice Address - Country:US
Practice Address - Phone:304-875-2330
Practice Address - Fax:304-875-2332
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP 6232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVRP 6232OtherPHARMACIST LICENSE