Provider Demographics
NPI:1366087850
Name:BARGER, MARY E
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:BARGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 222
Mailing Address - Street 2:
Mailing Address - City:HOLLY POND
Mailing Address - State:AL
Mailing Address - Zip Code:35083-0222
Mailing Address - Country:US
Mailing Address - Phone:850-226-2024
Mailing Address - Fax:
Practice Address - Street 1:1104 CULLMAN SHOPPING CTR NW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-2855
Practice Address - Country:US
Practice Address - Phone:256-736-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS55876183500000X
AL19567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist