Provider Demographics
NPI:1538446646
Name:SCALES, BARDA
Entity type:Individual
Prefix:
First Name:BARDA
Middle Name:
Last Name:SCALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 E SHELBY DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-7256
Mailing Address - Country:US
Mailing Address - Phone:901-794-3690
Mailing Address - Fax:901-794-3689
Practice Address - Street 1:3333 E SHELBY DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-7256
Practice Address - Country:US
Practice Address - Phone:901-794-3690
Practice Address - Fax:901-794-3689
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000038600183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician