Provider Demographics
NPI:1497344204
Name:UECKER, BARRY JOHN (RPH)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:JOHN
Last Name:UECKER
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 1:609 S US HIGHWAY 81
Mailing Address - Street 2:
Mailing Address - City:FREEMAN
Mailing Address - State:SD
Mailing Address - Zip Code:57029-2000
Mailing Address - Country:US
Mailing Address - Phone:605-925-4510
Mailing Address - Fax:605-925-7802
Practice Address - Street 1:609 S US HIGHWAY 81
Practice Address - Street 2:
Practice Address - City:FREEMAN
Practice Address - State:SD
Practice Address - Zip Code:57029-2000
Practice Address - Country:US
Practice Address - Phone:605-925-4510
Practice Address - Fax:605-925-4510
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4460183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist