Individual
GARY RAYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH, B.S. PHARM
Contact information
Practice address
2115 S MACARTHUR BLVD, SPRINGFIELD, IL 62704-4501
(217) 726-1003
Mailing address
5197 N CARPENTER RD, BUFFALO, IL 62515-7093
(217) 415-1764
(217) 364-5644
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
008653
KY
183500000X
Pharmacist
Primary
051034225
IL
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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