Provider Demographics
NPI:1720695901
Name:BARR, GARY M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:M
Last Name:BARR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 BLUE JAY WAY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-8416
Mailing Address - Country:US
Mailing Address - Phone:614-562-6893
Mailing Address - Fax:
Practice Address - Street 1:28 W MAIN ST
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-2938
Practice Address - Country:US
Practice Address - Phone:937-347-1200
Practice Address - Fax:937-708-8888
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03228238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist