Provider Demographics
NPI:1295155349
Name:NEL, BARRY GEORGE (RPH)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:GEORGE
Last Name:NEL
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 1:13110 W 75TH TER
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66216-3002
Mailing Address - Country:US
Mailing Address - Phone:913-907-8662
Mailing Address - Fax:
Practice Address - Street 1:13110 W 75TH TER
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66216-3002
Practice Address - Country:US
Practice Address - Phone:913-907-8662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13032183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1-13032OtherPHARMACY LICENCE NUMBER