Provider Demographics
NPI:1598779167
Name:BARNETT, JOHN D (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:BARNETT
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 1:14559 DANVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:LAUREL FORK
Mailing Address - State:VA
Mailing Address - Zip Code:24352-3758
Mailing Address - Country:US
Mailing Address - Phone:276-398-2620
Mailing Address - Fax:276-398-3884
Practice Address - Street 1:14559 DANVILLE PIKE
Practice Address - Street 2:
Practice Address - City:LAUREL FORK
Practice Address - State:VA
Practice Address - Zip Code:24352-3758
Practice Address - Country:US
Practice Address - Phone:276-398-2620
Practice Address - Fax:276-398-3884
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202009362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist