Provider Demographics
NPI:1891083226
Name:GRAY, RICHARD HOWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:HOWARD
Last Name:GRAY
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 1:1316 JOHN SMALL AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889
Mailing Address - Country:US
Mailing Address - Phone:252-946-1818
Mailing Address - Fax:252-975-5785
Practice Address - Street 1:1316 JOHN SMALL AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3843
Practice Address - Country:US
Practice Address - Phone:252-946-1818
Practice Address - Fax:252-975-5785
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist