Provider Demographics
NPI:1124391339
Name:BARHYDT, DAVID L (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:BARHYDT
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 1:21949 ANGELA DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526-8753
Mailing Address - Country:US
Mailing Address - Phone:574-533-1007
Mailing Address - Fax:
Practice Address - Street 1:4430 ELKHART RD
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-5863
Practice Address - Country:US
Practice Address - Phone:574-875-0236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26012752A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist