Provider Demographics
NPI:1144244153
Name:GRAY, DANIEL K (RPH)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:K
Last Name:GRAY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MANCHESTER SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-1401
Mailing Address - Country:US
Mailing Address - Phone:606-598-8831
Mailing Address - Fax:606-598-8838
Practice Address - Street 1:110 MANCHESTER SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-1401
Practice Address - Country:US
Practice Address - Phone:606-598-8831
Practice Address - Fax:606-598-8838
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist