Provider Demographics
NPI:1679861454
Name:BARNEYS PHARMACY GROVETOWN LLC
Entity Type:Organization
Organization Name:BARNEYS PHARMACY GROVETOWN LLC
Other - Org Name:BARNEYS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:706-799-8715
Mailing Address - Street 1:2604 PEACH ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-2406
Mailing Address - Country:US
Mailing Address - Phone:706-869-8535
Mailing Address - Fax:706-869-8285
Practice Address - Street 1:5135 WRIGHTSBORO RD
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-2803
Practice Address - Country:US
Practice Address - Phone:706-869-8535
Practice Address - Fax:706-869-8285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA013625332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies