Amanda Wray, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

P7045 Issued in ID

Practice address

98 Poplar St
Blackfoot, ID 83221-1758

Phone

(208) 782-2990

Fax

(208) 782-2931

NPI assigned

Jul 6, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1023504651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 KATES WAY",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832044606",
            "telephone_number": "208-604-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-782-2990",
            "fax_number": "208-782-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAY",
        "first_name": "AMANDA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P7045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "P7045",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Woodbury, PA
• Meghan L Woolstenhulme
• Jared Worthington, DDS
• Wray Dermatology
• Adam Wray, DO
• Lee Brock Wren, OD
• Shawn A Wren, CRNA
• Barbara Pancoast Young, LCSW
• Sandee K Young, LCSW
• Aimee Y Zhang, MD

• Pharmacist in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.