Provider Demographics
NPI:1477891729
Name:BARRETT, RIA GOBER
Entity Type:Individual
Prefix:
First Name:RIA
Middle Name:GOBER
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RIA
Other - Middle Name:LYNN
Other - Last Name:GOBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5581 THOMASTON RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31220-8119
Mailing Address - Country:US
Mailing Address - Phone:478-538-6372
Mailing Address - Fax:
Practice Address - Street 1:5581 THOMASTON RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31220-8119
Practice Address - Country:US
Practice Address - Phone:478-538-6372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025553183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist