Healthcare Provider Details

I. General information

NPI: 1205744026
Provider Name (Legal Business Name): HAILEY GRAY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6590 FOXBORO DR APT 316
CHATTANOOGA TN
37421-7574
US

IV. Provider business mailing address

6590 FOXBORO DR APT 316
CHATTANOOGA TN
37421-7574
US

V. Phone/Fax

Practice location:
  • Phone: 630-780-9255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number46615
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: