Provider Demographics
NPI:1871884171
Name:BARCH, JOHN SAMUEL (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:SAMUEL
Last Name:BARCH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14212 GRAND TRAVERSE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-9042
Mailing Address - Country:US
Mailing Address - Phone:704-756-7904
Mailing Address - Fax:
Practice Address - Street 1:701 CRESTDALE RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-1700
Practice Address - Country:US
Practice Address - Phone:704-844-4223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14808183500000X
SC9834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC9834OtherRPH LICENSE
NC14808OtherRPH LICENSE