Provider Demographics
NPI:1336467117
Name:BAIL, DEBORA JEAN (RPH)
Entity Type:Individual
Prefix:
First Name:DEBORA
Middle Name:JEAN
Last Name:BAIL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5722 CABIN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DAWES
Mailing Address - State:WV
Mailing Address - Zip Code:25054
Mailing Address - Country:US
Mailing Address - Phone:304-595-5071
Mailing Address - Fax:304-595-5714
Practice Address - Street 1:5722 CABIN CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:DAWES
Practice Address - State:WV
Practice Address - Zip Code:25054
Practice Address - Country:US
Practice Address - Phone:304-595-5071
Practice Address - Fax:304-595-5714
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist