Provider Demographics
NPI:1801198452
Name:WRAY, ANNE-MARIE (RPH)
Entity Type:Individual
Prefix:MS
First Name:ANNE-MARIE
Middle Name:
Last Name:WRAY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 VIRGINIA BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-5617
Mailing Address - Country:US
Mailing Address - Phone:757-486-1072
Mailing Address - Fax:757-486-2468
Practice Address - Street 1:3330 VIRGINIA BEACH BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-5617
Practice Address - Country:US
Practice Address - Phone:757-486-1072
Practice Address - Fax:757-486-2468
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist