Provider Demographics
NPI:1588230965
Name:WARWICK, BAILEY MORGAN
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:MORGAN
Last Name:WARWICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1742 HUNTSVILLE DR APT F
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-8610
Mailing Address - Country:US
Mailing Address - Phone:517-339-5832
Mailing Address - Fax:517-339-1035
Practice Address - Street 1:1589 HASLETT RD
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-8424
Practice Address - Country:US
Practice Address - Phone:517-339-5832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI20182120623183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician