Provider Demographics
NPI:1346556032
Name:BAILEY, GREGORY (RPH)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
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:BOX 1052 RT 819 S
Mailing Address - Street 2:
Mailing Address - City:MT. PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666
Mailing Address - Country:US
Mailing Address - Phone:724-547-5590
Mailing Address - Fax:724-542-8483
Practice Address - Street 1:RT 819 S
Practice Address - Street 2:
Practice Address - City:MT. PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666
Practice Address - Country:US
Practice Address - Phone:724-547-5590
Practice Address - Fax:724-542-8483
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038095L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist