Provider Demographics
NPI:1003835661
Name:BARNES, PATRICK (RPH)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:BARNES
Suffix:
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 1:75 SHORT ST NW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52405-4203
Mailing Address - Country:US
Mailing Address - Phone:319-396-6705
Mailing Address - Fax:319-654-0134
Practice Address - Street 1:75 SHORT ST NW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52405-4203
Practice Address - Country:US
Practice Address - Phone:319-396-6705
Practice Address - Fax:319-654-0134
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA162351835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy