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NPI Code Detail

MEDICARE: SUSAN K DAILEY

MEDICARE: SUSAN K DAILEY
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
1183500000XPharmacist11911AL

General Provider Information

NPI Number : 1588098081
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN K DAILEY
Provider Business Mailing Address
First Line : 1111 HIGHLAND AVE
Second Line :
City : SELMA
State : AL
Zip : 36703-4129
Country : US
Telephone Number : 334-875-4916
Fax Number : 334-875-7628
Provider Business Practice Location Address
First Line : 1111 HIGHLAND AVE
Second Line :
City : SELMA
State : AL
Zip : 36703-4129
Country : US
Telephone Number : 334-875-4916
Fax Number : 334-875-7628
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2013
Last Update Date : 09/03/2013

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Directions to “ SUSAN K DAILEY ” Practice Location

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