Provider Demographics
NPI:1609295559
Name:BRADY, HAILEY BARBEE (RPH)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:BARBEE
Last Name:BRADY
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 1:835 PINEY GREEN ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546
Mailing Address - Country:US
Mailing Address - Phone:910-219-3550
Mailing Address - Fax:910-219-3554
Practice Address - Street 1:835 PINEY GREEN ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546
Practice Address - Country:US
Practice Address - Phone:910-219-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC09204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist