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General NPI Number Information
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NPI Number | 1912660853
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Entity Type | Individual
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Provider Name | BAILEY GENE LEE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 3701 N 132ND ST
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City | OMAHA
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State | NE
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Zip | 68164-1849
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Country | US
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Telephone | 402-431-0665
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 S 132ND STREET
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City | OMAHA
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State | NE
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Zip | 68164
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 17294
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License Number State | NE
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