Provider Demographics
NPI:1285959742
Name:BAILEY, HORACE J (RPH)
Entity type:Individual
Prefix:
First Name:HORACE
Middle Name:J
Last Name:BAILEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 S THREE NOTCH ST
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-3710
Mailing Address - Country:US
Mailing Address - Phone:334-222-1131
Mailing Address - Fax:334-222-6212
Practice Address - Street 1:224 S THREE NOTCH ST
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-3710
Practice Address - Country:US
Practice Address - Phone:334-222-1131
Practice Address - Fax:334-222-6212
Is Sole Proprietor?:No
Enumeration Date:2010-03-28
Last Update Date:2010-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL7010OtherAL PHARMACIST LICENSE