Provider Demographics
NPI:1356343289
Name:GAY, BENT JR (RPH)
Entity type:Individual
Prefix:
First Name:BENT
Middle Name:
Last Name:GAY
Suffix:JR
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 1:1101 HILLCREST PKWY
Mailing Address - Street 2:C
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-3562
Mailing Address - Country:US
Mailing Address - Phone:478-272-8093
Mailing Address - Fax:
Practice Address - Street 1:1101 HILLCREST PKWY
Practice Address - Street 2:C
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3562
Practice Address - Country:US
Practice Address - Phone:478-272-8093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH015736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist