Provider Demographics
NPI:1891190682
Name:RAY, LORI (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2491 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-9455
Mailing Address - Country:US
Mailing Address - Phone:479-442-6060
Mailing Address - Fax:479-442-0606
Practice Address - Street 1:2491 N CENTER ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-9455
Practice Address - Country:US
Practice Address - Phone:479-442-6060
Practice Address - Fax:479-442-0606
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist