1881798833 NPI number — WRAYS INC

Table of content: (NPI 1881798833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881798833 NPI number — WRAYS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WRAYS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WRAYS THRIFTWAY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881798833
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7200 W NOB HILL BLVD
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
YAKIMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98908-1928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-966-0202
Provider Business Mailing Address Fax Number:
509-972-0809

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7200 W NOB HILL BLVD
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98908-1928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-965-0202
Provider Business Practice Location Address Fax Number:
509-966-0809
Provider Enumeration Date:
09/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
CHRIS
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
509-965-0202

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PHAR.CF.00002438 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4916601 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6031801 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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