Provider Demographics
NPI:1659376994
Name:RAYL, SCOTT ANDREW (RPH)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ANDREW
Last Name:RAYL
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 1:311 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HARBOR BEACH
Mailing Address - State:MI
Mailing Address - Zip Code:48441-1302
Mailing Address - Country:US
Mailing Address - Phone:989-479-9675
Mailing Address - Fax:989-479-3242
Practice Address - Street 1:114 S HURON AVE
Practice Address - Street 2:
Practice Address - City:HARBOR BEACH
Practice Address - State:MI
Practice Address - Zip Code:48441-1201
Practice Address - Country:US
Practice Address - Phone:989-315-8605
Practice Address - Fax:989-479-3242
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist