Provider Demographics
NPI:1609197128
Name:BAILEY COVE PHARMACY
Entity Type:Organization
Organization Name:BAILEY COVE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ODDO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:256-655-2828
Mailing Address - Street 1:10300 BAILEY COVE RD SE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-2635
Mailing Address - Country:US
Mailing Address - Phone:256-885-2191
Mailing Address - Fax:
Practice Address - Street 1:10300 BAILEY COVE RD SE
Practice Address - Street 2:SUITE 6
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35803-2635
Practice Address - Country:US
Practice Address - Phone:256-885-2191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
272665492183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty