Provider Demographics
NPI:1497028732
Name:RAY, HALEY BETH (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:BETH
Last Name:RAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4013 N MEADOW VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5032
Mailing Address - Country:US
Mailing Address - Phone:479-737-5555
Mailing Address - Fax:
Practice Address - Street 1:601 N GASKILL ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72740-6001
Practice Address - Country:US
Practice Address - Phone:479-738-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist