Provider Demographics
NPI:1417672304
Name:BAILEY, CHRISTA B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:B
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 GARLAND DRIVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622
Mailing Address - Country:US
Mailing Address - Phone:678-726-2111
Mailing Address - Fax:678-726-2113
Practice Address - Street 1:1020 GARLAND DRIVE
Practice Address - Street 2:SUITE 700
Practice Address - City:BOGART
Practice Address - State:GA
Practice Address - Zip Code:30622
Practice Address - Country:US
Practice Address - Phone:678-726-2111
Practice Address - Fax:678-726-2113
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist