Provider Demographics
NPI:1629146659
Name:BARTLETT, DONNA LEE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LEE
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BROOKS RD
Mailing Address - Street 2:
Mailing Address - City:PAXTON
Mailing Address - State:MA
Mailing Address - Zip Code:01612-1168
Mailing Address - Country:US
Mailing Address - Phone:508-373-5722
Mailing Address - Fax:508-373-0032
Practice Address - Street 1:25 FOSTER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1715
Practice Address - Country:US
Practice Address - Phone:508-373-5722
Practice Address - Fax:508-373-0032
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist