Provider Demographics
NPI:1326321852
Name:BARNES, VINCENT KEITH (RPH)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:KEITH
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 1:711 LANDSDOWNE CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2103
Mailing Address - Country:US
Mailing Address - Phone:270-765-7940
Mailing Address - Fax:270-982-3096
Practice Address - Street 1:711 LANDSDOWNE CT
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2103
Practice Address - Country:US
Practice Address - Phone:270-765-7940
Practice Address - Fax:270-982-3096
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY008103183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist