Basic Information
Provider Information
NPI: 1902198963
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARTON
FirstName: MARCUS
MiddleName: JOHN
NamePrefix:  
NameSuffix:  
Credential: PHARM.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 611 N IRON BRIDGE WAY
Address2:  
City: SPOKANE
State: WA
PostalCode: 992024932
CountryCode: US
TelephoneNumber: 5094448888
FaxNumber: 5094447806
Practice Location
Address1: 5620 S REGAL ST
Address2:  
City: SPOKANE
State: WA
PostalCode: 992237957
CountryCode: US
TelephoneNumber: 5094448888
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/10/2011
LastUpdateDate: 04/13/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/13/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X40621WAY Pharmacy Service ProvidersPharmacist 

No ID Information.


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