Provider Demographics
NPI:1255927430
Name:BAILEY, ANNA MARIE M (RPH)
Entity type:Individual
Prefix:MS
First Name:ANNA MARIE
Middle Name:M
Last Name:BAILEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:M
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:5 MARGAUX CT
Mailing Address - Street 2:
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-5735
Mailing Address - Country:US
Mailing Address - Phone:856-981-8155
Mailing Address - Fax:
Practice Address - Street 1:231 W BROAD ST
Practice Address - Street 2:
Practice Address - City:PAULSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08066-1652
Practice Address - Country:US
Practice Address - Phone:856-423-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RL01956300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist