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NPI Code Detail

MEDICARE: MRS. JENNIFER KAYE BAILEY R.PH

MEDICARE:  MRS. JENNIFER KAYE BAILEY  R.PH
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
1183500000XPharmacist03-3-17107OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
103-3-17107OTHEROHPHARMACIST

General Provider Information

NPI Number : 1275522773
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER KAYE BAILEY R.PH
Provider Business Mailing Address
First Line : 1589 PATRIOTS POINT SE
Second Line :
City : CANTON
State : OH
Zip : 44709
Country : US
Telephone Number : 330-754-6056
Fax Number :
Provider Business Practice Location Address
First Line : 1589 PATRIOTS PT SE
Second Line :
City : CANTON
State : OH
Zip : 44709-4826
Country : US
Telephone Number : 330-754-6056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 02/28/2011

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Directions to “ MRS. JENNIFER KAYE BAILEY R.PH” Practice Location

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