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
—
—
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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