Provider Demographics
NPI:1568711083
Name:BAILEY, STEPHEN BRETT (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:BRETT
Last Name:BAILEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 ASHLEY RIVER RD
Mailing Address - Street 2:APT 407
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4715
Mailing Address - Country:US
Mailing Address - Phone:843-862-4638
Mailing Address - Fax:
Practice Address - Street 1:2040 ASHLEY RIVER RD
Practice Address - Street 2:APT 407
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4715
Practice Address - Country:US
Practice Address - Phone:843-862-4638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13430183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist