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NPI Code Detail

MEDICARE: BAILEY DOW

MEDICARE: BAILEY DOW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist051302421IL

General Provider Information

NPI Number : 1205477080
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAILEY DOW
Provider Business Mailing Address
First Line : 1806 LEE ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-4838
Country : US
Telephone Number : 217-259-3477
Fax Number :
Provider Business Practice Location Address
First Line : 2945 S 6TH ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-4024
Country : US
Telephone Number : 217-788-5846
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2019
Last Update Date : 10/03/2019

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Directions to “ BAILEY DOW ” Practice Location

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