Healthcare Provider Details

I. General information

NPI: 1063759926
Provider Name (Legal Business Name): KEVIN BARNES PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2013
Last Update Date: 01/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2171 PRAIRIE CENTER PKWY
BRIGHTON CO
80601-7000
US

IV. Provider business mailing address

11318 LARSON LN
NORTHGLENN CO
80233-3119
US

V. Phone/Fax

Practice location:
  • Phone: 303-219-9055
  • Fax:
Mailing address:
  • Phone: 303-513-9748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA. 00019677
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 66693
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: