Provider Demographics
NPI:1710269436
Name:BARNES, GERALDINE HANTON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:HANTON
Last Name:BARNES
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 1:502 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-2155
Mailing Address - Country:US
Mailing Address - Phone:302-836-3740
Mailing Address - Fax:
Practice Address - Street 1:4114 STANTON OGLETOWN RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4169
Practice Address - Country:US
Practice Address - Phone:302-366-5660
Practice Address - Fax:302-391-1129
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-002285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA1-002285OtherSTATE LICENSE NUMBER