Provider Demographics
NPI:1609476159
Name:DRAY, ROBERT III (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:DRAY
Suffix:III
Gender:M
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 1:1140 ROSEWAY AVE SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2809
Mailing Address - Country:US
Mailing Address - Phone:330-219-2691
Mailing Address - Fax:
Practice Address - Street 1:1300 DORAL DR
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-1900
Practice Address - Country:US
Practice Address - Phone:330-758-0040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP448392183500000X
OH03232715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist