Provider Demographics
NPI:1104097237
Name:DR. RAY & ASSOCIATE, P.C.
Entity type:Organization
Organization Name:DR. RAY & ASSOCIATE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:JULIA
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-747-1176
Mailing Address - Street 1:7660 E PARHAM RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4378
Mailing Address - Country:US
Mailing Address - Phone:804-747-1176
Mailing Address - Fax:804-747-0874
Practice Address - Street 1:7660 E PARHAM RD
Practice Address - Street 2:SUITE 205
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4378
Practice Address - Country:US
Practice Address - Phone:804-747-1176
Practice Address - Fax:804-747-0874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034404174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6034616Medicaid
VAC01734Medicare PIN