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Organization
RAYCO CORPORATION
Active
Organization
RAYCO CORPORATION
Active
Other names
Stop and Shop Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMORY WAYNE ELWELL RPH (PHARMACY MANAGER)
(801) 399-4054
Entity
Organization
Contact information
Practice address
1130 WASHINGTON BLVD, OGDEN, UT 84404-4951
(801) 399-4054
(801) 399-4056
Mailing address
1130 WASHINGTON BLVD, OGDEN, UT 84404-4951
(801) 399-4054
(801) 399-4056
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
1326131703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326131703
STATE PHARMACY LICENSE
UT
01
—
4601856
NCPDP NUMBER
UT
Enumeration date
07/19/2006
Last updated
04/30/2008
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