Provider Demographics
NPI:1598083149
Name:BARTHS OF MATTITUCK INC
Entity Type:Organization
Organization Name:BARTHS OF MATTITUCK INC
Other - Org Name:BARTH'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-727-2125
Mailing Address - Street 1:32 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2423
Mailing Address - Country:US
Mailing Address - Phone:631-727-2125
Mailing Address - Fax:631-727-2199
Practice Address - Street 1:195 LOVE LN
Practice Address - Street 2:
Practice Address - City:MATTITUCK
Practice Address - State:NY
Practice Address - Zip Code:11952-3277
Practice Address - Country:US
Practice Address - Phone:631-727-2125
Practice Address - Fax:631-727-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy