Provider Demographics
NPI:1134594047
Name:RAY, JOSHUA (PHARMD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
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 1:15500 S NORRISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-7633
Mailing Address - Country:US
Mailing Address - Phone:814-573-7386
Mailing Address - Fax:
Practice Address - Street 1:30500 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-3600
Practice Address - Country:US
Practice Address - Phone:440-943-2127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03334409183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist