Organization
FREDERICK RAY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL V TAVARES PHARMD (PHARMACY MANAGER)
(860) 367-4773
Entity
Organization
Contact information
Practice address
26 FALLS RD, MOODUS, CT 06469-1262
(860) 367-4773
Mailing address
12 KEYBOARD LN, IVORYTON, CT 06442-1265
(860) 367-4773
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
01/27/2020
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