Provider Demographics
NPI:1073239083
Name:HEALTHSTAT WELLNESS PASCO-PORT RICHEY DISPENSING
Entity type:Organization
Organization Name:HEALTHSTAT WELLNESS PASCO-PORT RICHEY DISPENSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOBIAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-366-1655
Mailing Address - Street 1:10 W MARKET ST STE 2900
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-2964
Mailing Address - Country:US
Mailing Address - Phone:866-434-3255
Mailing Address - Fax:
Practice Address - Street 1:8606 GOVERNMENT DR STE 3
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-5510
Practice Address - Country:US
Practice Address - Phone:704-529-6161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Single Specialty