Provider Demographics
NPI:1437186475
Name:BARRETT, UPTON JEROME (RPH)
Entity Type:Individual
Prefix:
First Name:UPTON
Middle Name:JEROME
Last Name:BARRETT
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 1:105 EAGLE SPRU TRAIL
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152
Mailing Address - Country:US
Mailing Address - Phone:704-313-3150
Mailing Address - Fax:
Practice Address - Street 1:756 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3941
Practice Address - Country:US
Practice Address - Phone:828-245-0786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6762183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist