Provider Demographics
NPI:1215027313
Name:BARHAM, DARROTH LEONARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:DARROTH
Middle Name:LEONARD
Last Name:BARHAM
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:PO BOX 645
Mailing Address - Street 2:122 NORFLEET DR
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668
Mailing Address - Country:US
Mailing Address - Phone:662-562-4712
Mailing Address - Fax:662-562-0644
Practice Address - Street 1:122 NORFLEET DR
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668
Practice Address - Country:US
Practice Address - Phone:662-562-4712
Practice Address - Fax:662-562-0644
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE5301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist