Provider Demographics
NPI:1740653187
Name:RAY, MITCHELL TROY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:TROY
Last Name:RAY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-3925
Mailing Address - Country:US
Mailing Address - Phone:330-432-4509
Mailing Address - Fax:
Practice Address - Street 1:418 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-3925
Practice Address - Country:US
Practice Address - Phone:330-432-4509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25179183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist