Provider Demographics
NPI:1275548893
Name:BARRIER ISLAND HOLDING CO
Entity Type:Organization
Organization Name:BARRIER ISLAND HOLDING CO
Other - Org Name:BARRIER ISLAND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-472-8866
Mailing Address - Street 1:1456 PERIWINKLE WAY # A
Mailing Address - Street 2:STE A
Mailing Address - City:SANIBEL
Mailing Address - State:FL
Mailing Address - Zip Code:33957-4512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1456 PERIWINKLE WAY # A
Practice Address - Street 2:STE A
Practice Address - City:SANIBEL
Practice Address - State:FL
Practice Address - Zip Code:33957-4512
Practice Address - Country:US
Practice Address - Phone:239-472-8866
Practice Address - Fax:239-472-8880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH15711333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1026485OtherOTHER ID NUMBER-COMMERCIAL NUMBER