Organization
BEN-RAY INC.
Active
Other names
Evans Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENTLEY FRED HAWLEY (PRESIDENT)
(432) 337-2361
Entity
Organization
Contact information
Practice address
310 DOTSY AVE, ODESSA, TX 79763-4342
(432) 337-2361
(432) 337-0310
Mailing address
PO BOX 4474, 310 N. DOTSY AVE, ODESSA, TX 79760-4474
(432) 337-2361
(432) 337-0310
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
01918
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140119
—
TX
Enumeration date
08/29/2005
Last updated
08/18/2008
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