Provider Demographics
NPI:1841531423
Name:RAY, ANITA ELIZABETH (RPH)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:ELIZABETH
Last Name:RAY
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 1:40 W MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:OLD FORT
Mailing Address - State:NC
Mailing Address - Zip Code:28762
Mailing Address - Country:US
Mailing Address - Phone:828-668-4347
Mailing Address - Fax:
Practice Address - Street 1:40 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:OLD FORT
Practice Address - State:NC
Practice Address - Zip Code:28762
Practice Address - Country:US
Practice Address - Phone:828-668-4347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist