Healthcare Provider Details

I. General information

NPI: 1881796225
Provider Name (Legal Business Name): BARNES PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 MAIN ST
VAN BUREN MO
63965
US

IV. Provider business mailing address

PO BOX 361
VAN BUREN MO
63965-0361
US

V. Phone/Fax

Practice location:
  • Phone: 573-323-8159
  • Fax: 573-323-4436
Mailing address:
  • Phone: 573-323-8159
  • Fax: 573-323-4436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2003031703
License Number StateMO

VIII. Authorized Official

Name: RITA BARNES
Title or Position: PRESIDENT
Credential:
Phone: 573-323-8159