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General NPI Number Information
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NPI Number | 1629352448
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Entity Type | Organization
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Legal Business Name | BAILEYS PHARMACY
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 5623 COLUMBIA PIKE
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City | FALLS CHURCH
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State | VA
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Zip | 22041-2866
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Country | US
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Telephone | 571-490-2153
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1655
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City | FALLS CHURCH
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State | VA
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Zip | 22041-0655
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Country | US
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Telephone | 571-490-2153
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. IBRAHIM MOHAMED
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Credential |
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Telephone | 571-490-2153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 0201004427
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License Number State | VA
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