MEDICARE: KATHRYN BARRY RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	44502	CA

General Provider Information

NPI Number	:	1093356719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN BARRY RPH

Provider Business Mailing Address
First Line	:	4611 JANET PL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-1909
Country	:	US
Telephone Number	:	949-228-0765
Fax Number	:

Provider Business Practice Location Address
First Line	:	9610 RIDGEHAVEN CT STE A
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-5603
Country	:	US
Telephone Number	:	619-543-5231
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2019
Last Update Date	:	10/03/2019

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