Provider Demographics
NPI:1861834848
Name:BAILEY, PAUL BRADFORD (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:BRADFORD
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:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29702-0355
Mailing Address - Country:US
Mailing Address - Phone:864-490-4380
Mailing Address - Fax:
Practice Address - Street 1:113 W BUFORD ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-3001
Practice Address - Country:US
Practice Address - Phone:864-488-3036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12600183500000X
NC22277183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist