Healthcare Provider Details

I. General information

NPI: 1801915855
Provider Name (Legal Business Name): RUAN BAILEY R.PH BS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15917 BOUNDARY DR HWY 5
ASHLAND MS
38603
US

IV. Provider business mailing address

1161 HARRIS CHAPEL RD
MICHIGAN CITY MS
38647-9216
US

V. Phone/Fax

Practice location:
  • Phone: 662-224-8922
  • Fax: 662-224-9111
Mailing address:
  • Phone: 662-224-3532
  • Fax: 662-224-9111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberT08057
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: