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General NPI Number Information
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NPI Number | 1023755279
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Entity Type | Individual
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Provider Name | BAILEY PETREY RAY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 2602 FLORENCE BLVD
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City | FLORENCE
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State | AL
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Zip | 35630-2864
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Country | US
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Telephone | 256-764-0436
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Fax |
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Provider Business Mailing Address
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Address Line | 131 FOX LOOP
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City | MUSCLE SHOALS
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State | AL
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Zip | 35661-1470
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Country | US
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Telephone | 334-654-0116
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21367
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License Number State | AL
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