Provider Demographics
NPI:1033411178
Name:DRAYER, DAVID RANDALL (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RANDALL
Last Name:DRAYER
Suffix:
Gender:
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 SUNNYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-1921
Mailing Address - Country:US
Mailing Address - Phone:740-849-2768
Mailing Address - Fax:
Practice Address - Street 1:636 E MAIN ST
Practice Address - Street 2:
Practice Address - City:POMEROY
Practice Address - State:OH
Practice Address - Zip Code:45769-1161
Practice Address - Country:US
Practice Address - Phone:740-992-2955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03236382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist