Provider Demographics
NPI:1568451342
Name:BARRYS DRUG CENTER INC
Entity Type:Organization
Organization Name:BARRYS DRUG CENTER INC
Other - Org Name:BARRYS DRUG CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:785-776-8833
Mailing Address - Street 1:414 POYNTZ AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-6039
Mailing Address - Country:US
Mailing Address - Phone:785-776-8833
Mailing Address - Fax:785-776-3784
Practice Address - Street 1:414 POYNTZ AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-6039
Practice Address - Country:US
Practice Address - Phone:785-776-8833
Practice Address - Fax:785-776-3784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
KS2-132383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100437480AMedicaid
2031112OtherPK
2031112OtherPK