Provider Demographics
NPI:1679104202
Name:BARBELA, NIRANT
Entity type:Individual
Prefix:
First Name:NIRANT
Middle Name:
Last Name:BARBELA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 BILL WIGINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-6853
Mailing Address - Country:US
Mailing Address - Phone:706-692-1255
Mailing Address - Fax:706-692-1258
Practice Address - Street 1:115 BILL WIGINGTON PKWY
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-6853
Practice Address - Country:US
Practice Address - Phone:706-692-1255
Practice Address - Fax:706-692-1258
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-02
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0202611835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist