Organization
GRAY DRUG & FOUNTAIN INC
Active
Other names
Gray Drug & Fountain
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK GRAY PHARM D (PHARMACIST IN CHARGE)
(785) 534-1200
Entity
Organization
Contact information
Practice address
100 S MILL ST, BELOIT, KS 67420-3237
(785) 534-1200
(785) 534-1202
Mailing address
100 S MILL ST, BELOIT, KS 67420-3237
(785) 534-1200
(785) 534-1202
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-10445
KS
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201072760A
—
KS
05
—
201072760B
—
KS
01
—
2140045
PK
—
Enumeration date
04/10/2013
Last updated
06/17/2014
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