MEDICARE: GAY H MASSEY RPH

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	10742	AL

General Provider Information

NPI Number	:	1497716195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAY H MASSEY RPH

Provider Business Mailing Address
First Line	:	131 GREEN DR
Second Line	:	PO BOX 29
City	:	SECTION
State	:	AL
Zip	:	35771-7411
Country	:	US
Telephone Number	:	256-228-6443
Fax Number	:	256-228-3179

Provider Business Practice Location Address
First Line	:	5337 TAMMY LITTLE DR
Second Line	:
City	:	SECTION
State	:	AL
Zip	:	35771-7206
Country	:	US
Telephone Number	:	256-228-7179
Fax Number	:	256-228-3179

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	08/21/2012

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Directions to “ GAY H MASSEY RPH” Practice Location

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