Provider Demographics
NPI:1851537948
Name:GILES, BOBBY MICHAEL (RPH)
Entity Type:Individual
Prefix:
First Name:BOBBY
Middle Name:MICHAEL
Last Name:GILES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:RAINSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35986-6062
Mailing Address - Country:US
Mailing Address - Phone:256-505-2256
Mailing Address - Fax:256-638-2257
Practice Address - Street 1:125 ARBOR LN
Practice Address - Street 2:
Practice Address - City:RAINSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35986-6062
Practice Address - Country:US
Practice Address - Phone:256-505-2256
Practice Address - Fax:256-638-2257
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist