Provider Demographics
NPI:1063759926
Name:BARNES, KEVIN (PHARMD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:BARNES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11318 LARSON LN
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-3119
Mailing Address - Country:US
Mailing Address - Phone:303-513-9748
Mailing Address - Fax:
Practice Address - Street 1:2171 PRAIRIE CENTER PKWY
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-7000
Practice Address - Country:US
Practice Address - Phone:303-219-9055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA. 00019677183500000X
CARPH 66693183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist