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General NPI Number Information
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NPI Number | 1700925500
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Entity Type | Organization
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Legal Business Name | J M BAILEY PHARMACY INC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 301 SHIRLEY AVE
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City | DOUGLAS
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State | GA
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Zip | 31533-2333
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Country | US
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Telephone | 912-384-7026
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Fax | 912-384-9554
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Provider Business Mailing Address
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Address Line | 301 SHIRLEY AVE
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City | DOUGLAS
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State | GA
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Zip | 31533-2333
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Country | US
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Telephone | 912-384-7026
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Fax | 912-384-9554
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Authorized Official
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Title or Position | PRES OF CORP
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Name | JERRELL BAILEY
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Credential |
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Telephone | 912-384-7026
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE005248
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License Number State | GA
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