Provider Demographics
NPI:1023755279
Name:RAY, BAILEY PETREY (PHARMD)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:PETREY
Last Name:RAY
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 1:131 FOX LOOP
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-1470
Mailing Address - Country:US
Mailing Address - Phone:334-654-0116
Mailing Address - Fax:
Practice Address - Street 1:2602 FLORENCE BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-2864
Practice Address - Country:US
Practice Address - Phone:256-764-0436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist