Provider Demographics
NPI:1770807729
Name:BARBEN, GARY R (PHARMD)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:R
Last Name:BARBEN
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:PO BOX 120
Mailing Address - Street 2:
Mailing Address - City:ANNABELLA
Mailing Address - State:UT
Mailing Address - Zip Code:84711-0120
Mailing Address - Country:US
Mailing Address - Phone:435-896-5438
Mailing Address - Fax:435-896-8478
Practice Address - Street 1:1080 S HIGHWAY 118
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84701-3115
Practice Address - Country:US
Practice Address - Phone:435-896-8489
Practice Address - Fax:435-896-8478
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5323000-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist