Provider Demographics
NPI:1316668528
Name:ESCH, BAILEE
Entity type:Individual
Prefix:
First Name:BAILEE
Middle Name:
Last Name:ESCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 MILL ST
Mailing Address - Street 2:
Mailing Address - City:GLEASON
Mailing Address - State:TN
Mailing Address - Zip Code:38229-7435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:134 COURTRIGHT RD
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-1606
Practice Address - Country:US
Practice Address - Phone:731-587-3819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46306183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist