Provider Demographics
NPI:1497147581
Name:BARETTA, DARREN (PHARM D)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:BARETTA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3954 LENAMARIE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-0114
Mailing Address - Country:US
Mailing Address - Phone:702-807-6685
Mailing Address - Fax:
Practice Address - Street 1:3954 LENAMARIE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-0114
Practice Address - Country:US
Practice Address - Phone:702-807-6685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist