Provider Demographics
NPI:1154041192
Name:RAY'S CITY DRUG, INC.
Entity type:Organization
Organization Name:RAY'S CITY DRUG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSABROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-832-2626
Mailing Address - Street 1:105 E HENRY ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:TX
Mailing Address - Zip Code:76531-1909
Mailing Address - Country:US
Mailing Address - Phone:254-386-3121
Mailing Address - Fax:254-386-3359
Practice Address - Street 1:105 E HENRY ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:TX
Practice Address - Zip Code:76531-1909
Practice Address - Country:US
Practice Address - Phone:254-386-3121
Practice Address - Fax:254-386-3359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34416OtherTEXAS STATE BOARD OF PHARMACY