Provider Demographics
NPI:1316243199
Name:BAILEY, AUSTIN JEFFERY (RPH)
Entity type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:JEFFERY
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 1:24017 MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36421-5954
Mailing Address - Country:US
Mailing Address - Phone:334-493-3417
Mailing Address - Fax:
Practice Address - Street 1:324 W BYPASS
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-2514
Practice Address - Country:US
Practice Address - Phone:334-427-1111
Practice Address - Fax:334-427-1116
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL110728183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100002818Medicaid
AL0191670002Medicare UPIN