Provider Demographics
NPI:1760747653
Name:BARKER, GARY DEAN (RPH)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:DEAN
Last Name:BARKER
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 1:2700 STATE ST STE F13
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0674
Mailing Address - Country:US
Mailing Address - Phone:701-530-5800
Mailing Address - Fax:701-530-5805
Practice Address - Street 1:2700 STATE ST STE F13
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0674
Practice Address - Country:US
Practice Address - Phone:701-530-5800
Practice Address - Fax:701-530-5805
Is Sole Proprietor?:No
Enumeration Date:2012-07-07
Last Update Date:2012-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist