Gray Pharm Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY.007717-IR Issued in LA

Legal business name

GRAY PHARM INC

Doing business as

The Pharmacy Shoppe

Practice address

1510 S 2ND St
Monroe, LA 71202-2742

Phone

(318) 323-2883

Fax

(318) 323-8732

NPI assigned

Jun 8, 2016

Organization subpart

No

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

Authorized official

Name

Bartholemew Hardwell

Title

Owner

Phone

(318) 323-2883

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Pharmacy Shoppe Doing business as

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1508215872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 S 2ND ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712022742",
            "telephone_number": "318-323-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S 2ND ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712022742",
            "telephone_number": "318-323-2883",
            "fax_number": "318-323-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAY PHARM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "HARDWELL",
        "authorized_official_first_name": "BARTHOLEMEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-323-2883"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "PHY.007717-IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2205102",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pharmacy Shoppe",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Pharmacy Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hailey Graves
• Kaitlin Graves, LMSW
• White S Graves, D.O.
• White Solomon Graves IV, M.D.
• Gray Pharm Inc
• Gray Pharm Incorporated
• Brandi Gray
• Brynesha Lanette Gray, BSW, RSW
• Ella L Gray, LPC
• Joann Gray

• Community/Retail Pharmacy in Monroe, LA
• Providers in Monroe, LA by specialty
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.