Healthcare Provider Details

I. General information

NPI: 1689784407
Provider Name (Legal Business Name): CHARLES EMMANUEL BARKLEY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 HOSPITAL DR
RATON NM
87740-2002
US

IV. Provider business mailing address

174 HOSPITAL DR
RATON NM
87740-2002
US

V. Phone/Fax

Practice location:
  • Phone: 575-395-7559
  • Fax:
Mailing address:
  • Phone: 575-395-7559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28R102012900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00007465
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: