Provider Demographics
NPI:1326332495
Name:BARNELL, ANDREW DALE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DALE
Last Name:BARNELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4459 FOXFIRE TRL
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-9572
Mailing Address - Country:US
Mailing Address - Phone:269-599-4833
Mailing Address - Fax:
Practice Address - Street 1:5700 BECKLEY RD
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4189
Practice Address - Country:US
Practice Address - Phone:269-979-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037056183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist