Provider Demographics
NPI:1497716195
Name:MASSEY, GAY H (RPH)
Entity Type:Individual
Prefix:
First Name:GAY
Middle Name:H
Last Name:MASSEY
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 1:131 GREEN DR
Mailing Address - Street 2:PO BOX 29
Mailing Address - City:SECTION
Mailing Address - State:AL
Mailing Address - Zip Code:35771-7411
Mailing Address - Country:US
Mailing Address - Phone:256-228-6443
Mailing Address - Fax:256-228-3179
Practice Address - Street 1:5337 TAMMY LITTLE DR
Practice Address - Street 2:
Practice Address - City:SECTION
Practice Address - State:AL
Practice Address - Zip Code:35771-7206
Practice Address - Country:US
Practice Address - Phone:256-228-7179
Practice Address - Fax:256-228-3179
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10742183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist