Provider Demographics
NPI:1841203007
Name:RAYS PHARMACY INC
Entity Type:Organization
Organization Name:RAYS PHARMACY INC
Other - Org Name:QIC PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:817-473-1147
Mailing Address - Street 1:1831 E BROAD ST
Mailing Address - Street 2:STE# 207
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-9170
Mailing Address - Country:US
Mailing Address - Phone:817-473-1147
Mailing Address - Fax:817-473-4631
Practice Address - Street 1:1831 E BROAD ST STE 213
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-9171
Practice Address - Country:US
Practice Address - Phone:817-477-2525
Practice Address - Fax:817-473-4136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336M0002X
TX144403336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143702Medicaid
2099430OtherPK