Provider Demographics
NPI:1104034214
Name:BARTISH, CHRISTINE M (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:BARTISH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 PLOMOSA PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6904
Mailing Address - Country:US
Mailing Address - Phone:702-360-5684
Mailing Address - Fax:
Practice Address - Street 1:1940 VILLAGE CENTER CIR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6236
Practice Address - Country:US
Practice Address - Phone:702-240-3788
Practice Address - Fax:702-240-0112
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist