Loray Thomas Childs, RPH
Individual provider Active NPI Pharmacist · Gray, GA
NPI 1780717223 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1780717223
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 15827 (GA)
- Practice address
- 126 W Clinton St
Gray, GA 31032-5322 - Phone
- (478) 986-3161
- Fax
- (478) 986-5056
- NPI assigned
- Mar 13, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15827 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15827 | GA | Yes |
Addresses
Primary practice location
126 W Clinton St
Gray, GA 31032-5322
Mailing address
PO Box 1544
Gray, GA 31032-1544
Phone (478) 986-9652
Other providers in Gray, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.