# GRAY PHARM INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Pharmacy Shoppe
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114413705
- **Authorized official:** BARTHOLEMEW HARDWELL (PHARMACIST)
- **Authorized official phone:** (318) 323-2883

## Contact information

- **Practice address:** 1510 S 2ND ST, MONROE, LA 71202-2742
- **Practice address phone:** (318) 323-2883
- **Practice address fax:** (318) 323-2883
- **Mailing address:** 1510 S 2ND ST, MONROE, LA 71202-2742
- **Mailing address phone:** (318) 323-2883
- **Mailing address fax:** (318) 323-2883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHY.007717-IR | LA | Yes |

## Other

- **Enumeration date:** 07/06/2018
- **Last updated:** 07/06/2018