Provider Demographics
NPI:1902023385
Name:EFROS, BARRY S (RPH)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:S
Last Name:EFROS
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 1:33099 OAK HOLLOW ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1966
Mailing Address - Country:US
Mailing Address - Phone:248-932-6359
Mailing Address - Fax:248-626-5183
Practice Address - Street 1:6510 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-3011
Practice Address - Country:US
Practice Address - Phone:248-626-2525
Practice Address - Fax:248-626-5183
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302024344OtherPHARMACIST LISCENSE NUMBE