Provider Demographics
NPI:1427371244
Name:BARR, CRAIGG L (PHARMD)
Entity Type:Individual
Prefix:
First Name:CRAIGG
Middle Name:L
Last Name:BARR
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 1:67 OUTLOOK WAY
Mailing Address - Street 2:
Mailing Address - City:STARKSBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05487
Mailing Address - Country:US
Mailing Address - Phone:802-870-3119
Mailing Address - Fax:
Practice Address - Street 1:308 SHELBURNE ROAD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401
Practice Address - Country:US
Practice Address - Phone:802-864-8154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0330058751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist