Provider Demographics
NPI:1790389187
Name:BARR, THERESA (RPH)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:
Last Name:BARR
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 1:61 HARLAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3402
Mailing Address - Country:US
Mailing Address - Phone:908-208-0557
Mailing Address - Fax:
Practice Address - Street 1:1 ATT WAY
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921-2693
Practice Address - Country:US
Practice Address - Phone:908-719-6592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI021487003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy