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General NPI Number Information
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NPI Number | 1073239083
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Entity Type | Organization
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Legal Business Name | HEALTHSTAT WELLNESS PASCO-PORT RICHEY DISPENSING
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 8606 GOVERNMENT DR STE 3
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City | NEW PORT RICHEY
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State | FL
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Zip | 34654-5510
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Country | US
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Telephone | 704-529-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 10 W MARKET ST STE 2900
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-2964
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Country | US
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Telephone | 866-434-3255
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TOBIAS D. BARKER
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Credential | MD
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Telephone | 781-366-1655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number |
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License Number State |
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