Provider Demographics
NPI:1548209083
Name:BARTHOLOMEW, MARY GAIL (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:GAIL
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:17227 BARTH AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MO
Mailing Address - Zip Code:65281-2101
Mailing Address - Country:US
Mailing Address - Phone:660-222-3463
Mailing Address - Fax:660-222-3392
Practice Address - Street 1:1003 N US HIGHWAY 65
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:MO
Practice Address - Zip Code:64633-1972
Practice Address - Country:US
Practice Address - Phone:660-542-1111
Practice Address - Fax:660-542-3051
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO5229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist