1114242146 NPI number — MR. ROY ALEXANDER BARNETT JR. PHARMACIST02

Table of content: MR. ROY ALEXANDER BARNETT JR. PHARMACIST02 (NPI 1114242146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114242146 NPI number — MR. ROY ALEXANDER BARNETT JR. PHARMACIST02

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARNETT
Provider First Name:
ROY
Provider Middle Name:
ALEXANDER
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
PHARMACIST02
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114242146
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 220
Provider Second Line Business Mailing Address:
304 WASHINGTON STREET
Provider Business Mailing Address City Name:
MARION
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36756-0220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-683-6166
Provider Business Mailing Address Fax Number:
334-683-9621

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
304 WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARION
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36756-2332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-683-6166
Provider Business Practice Location Address Fax Number:
334-683-9621
Provider Enumeration Date:
04/01/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  5393 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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