Provider Demographics
NPI:1013290006
Name:BAILEY, AMY L (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5140 W BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-2971
Mailing Address - Country:US
Mailing Address - Phone:602-237-7001
Mailing Address - Fax:877-376-9490
Practice Address - Street 1:2250 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-6947
Practice Address - Country:US
Practice Address - Phone:602-305-4421
Practice Address - Fax:877-376-9490
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2020-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60251478183500000X, 1835P0018X
ORRPH-0012827183500000X, 1835P0018X
AZS018716183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist