Provider Demographics
NPI:1316073307
Name:RAYMOND, NORMA M (RPH)
Entity type:Individual
Prefix:MR
First Name:NORMA
Middle Name:M
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:106 RAYMOND GDN
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MS
Mailing Address - Zip Code:39073-4402
Mailing Address - Country:US
Mailing Address - Phone:601-845-5647
Mailing Address - Fax:601-845-5647
Practice Address - Street 1:106 RAYMOND GDN
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MS
Practice Address - Zip Code:39073-4402
Practice Address - Country:US
Practice Address - Phone:601-845-5647
Practice Address - Fax:601-845-5647
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE07593183500000X
AL07705183500000X
LA17894183500000X
MT3679183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist