Provider Demographics
NPI:1629104948
Name:BARGE, JOE PERKINS (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:PERKINS
Last Name:BARGE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4551 SASSAFRAS TEA RD
Mailing Address - Street 2:
Mailing Address - City:CAMILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31730-5921
Mailing Address - Country:US
Mailing Address - Phone:229-336-7794
Mailing Address - Fax:
Practice Address - Street 1:200 E OAKRIDGE DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31705-3676
Practice Address - Country:US
Practice Address - Phone:229-434-4684
Practice Address - Fax:229-432-5560
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH009867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist