Provider Demographics
NPI:1013297902
Name:PITTMAN, BARBARA KISER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:KISER
Last Name:PITTMAN
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 1:5921 BEAVER DAM LN
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-5211
Mailing Address - Country:US
Mailing Address - Phone:704-545-1568
Mailing Address - Fax:
Practice Address - Street 1:5921 BEAVER DAM LN
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-5211
Practice Address - Country:US
Practice Address - Phone:704-545-1568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist