Provider Demographics
NPI:1891075438
Name:BARELL, ROBERT J (BS PHARMACY)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:BARELL
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 TEABERRY AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-3354
Mailing Address - Country:US
Mailing Address - Phone:856-520-4021
Mailing Address - Fax:
Practice Address - Street 1:1015 N MAIN RD
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-2538
Practice Address - Country:US
Practice Address - Phone:856-691-1465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01631400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0190080Medicaid