Provider Demographics
NPI:1063469294
Name:RAYS PHARMACY INC
Entity type:Organization
Organization Name:RAYS PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TEBOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-754-3312
Mailing Address - Street 1:414 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:QUINTER
Mailing Address - State:KS
Mailing Address - Zip Code:67752-5205
Mailing Address - Country:US
Mailing Address - Phone:785-754-3312
Mailing Address - Fax:785-754-3844
Practice Address - Street 1:414 MAIN ST
Practice Address - Street 2:
Practice Address - City:QUINTER
Practice Address - State:KS
Practice Address - Zip Code:67752
Practice Address - Country:US
Practice Address - Phone:785-754-3312
Practice Address - Fax:785-754-3844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X, 332B00000X, 333600000X
KS2-081293336L0003X
KS2081293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100439990BMedicaid
2026129OtherPK
0523290001Medicare NSC
KS100439990BMedicaid