Ray Harris Branson, PHARMD. RPH
Individual provider Active NPI Pharmacist · Gallup, NM
NPI 1902805476 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1902805476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 16334 (NC)
- Practice address
- 516 Nizhoni Blvd
Gallup, NM 87301-5748 - Phone
- (505) 722-1185
- NPI assigned
- Jul 18, 2005
- Sex
- Male
- 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
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16334 | NC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16334 | NC | Yes |
Addresses
Primary practice location
516 Nizhoni Blvd
Gallup, NM 87301-5748
Mailing address
PO Box 4964
Gallup, NM 87305-4964
Phone (505) 778-5936
Other providers in Gallup, NM
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.