Healthcare Provider Details

I. General information

NPI: 1821373267
Provider Name (Legal Business Name): DEANDREA KING BARRIERE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2011
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 HIGHWAY 11 N
PICAYUNE MS
39466-2065
US

IV. Provider business mailing address

205 SARAH LN
SLIDELL LA
70460-6546
US

V. Phone/Fax

Practice location:
  • Phone: 601-799-2087
  • Fax: 601-799-2971
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number010434
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number018771
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: