MEDICARE: JAMES BRADLEY GAY PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH027184	GA

General Provider Information

NPI Number	:	1275122533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES BRADLEY GAY PHARMD

Provider Business Mailing Address
First Line	:	15 MUELLER BND
Second Line	:
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-4990
Country	:	US
Telephone Number	:	912-484-6786
Fax Number	:

Provider Business Practice Location Address
First Line	:	481 E G MILES PKWY
Second Line	:
City	:	HINESVILLE
State	:	GA
Zip	:	31313-4006
Country	:	US
Telephone Number	:	912-876-8125
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2021
Last Update Date	:	01/12/2021

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