Healthcare Provider Details

I. General information

NPI: 1033559422
Provider Name (Legal Business Name): BARRYS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2013
Last Update Date: 06/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 7TH ST
HENDERSON KY
42420-2838
US

IV. Provider business mailing address

426 7TH ST
HENDERSON KY
42420-2838
US

V. Phone/Fax

Practice location:
  • Phone: 270-869-9197
  • Fax: 270-844-8045
Mailing address:
  • Phone: 270-869-9197
  • Fax: 270-844-8045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberMG0747
License Number StateKY

VIII. Authorized Official

Name: MR. TERRYE GOWER
Title or Position: PRESIDENT
Credential: RPH
Phone: 270-869-9197