Gary Brandon Bailey Jr., PHARM D
Individual provider Active NPI Pharmacist · Brunswick, GA
NPI 1598892788 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1598892788
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH021079 (GA)
- Practice address
- 5711 Altama Ave
Suite J
Brunswick, GA 31525-2240 - Phone
- (912) 264-2622
- Fax
- (912) 264-1392
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH021079 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Pharmacy LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH021079 | GA | Yes |
Addresses
Primary practice location
5711 Altama Ave
Suite J
Brunswick, GA 31525-2240
Mailing address
104 Lincoln PL
E-2
Saint Simons Island, GA 31522-3626
Phone (912) 506-6480
Other providers in Brunswick, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.