Provider Demographics
NPI:1265925028
Name:PHARMACY BARN
Entity type:Organization
Organization Name:PHARMACY BARN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:913-626-1315
Mailing Address - Street 1:9746 HIGHWAY 62/412
Mailing Address - Street 2:
Mailing Address - City:VIOLA
Mailing Address - State:AR
Mailing Address - Zip Code:72583
Mailing Address - Country:US
Mailing Address - Phone:870-458-2223
Mailing Address - Fax:
Practice Address - Street 1:9746 HIGHWAY 62/412
Practice Address - Street 2:
Practice Address - City:VIOLA
Practice Address - State:AR
Practice Address - Zip Code:72583
Practice Address - Country:US
Practice Address - Phone:870-458-2223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy