Provider Demographics
NPI:1215156393
Name:BARNES HEALTHCARE OF FL LLC
Entity type:Organization
Organization Name:BARNES HEALTHCARE OF FL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:229-245-6039
Mailing Address - Street 1:PO BOX 1187
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31603-1187
Mailing Address - Country:US
Mailing Address - Phone:229-245-6039
Mailing Address - Fax:888-276-7881
Practice Address - Street 1:1833 N EAST AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-6276
Practice Address - Country:US
Practice Address - Phone:850-785-2480
Practice Address - Fax:866-421-6133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101747104Medicaid
FL105035100Medicaid
FL030829302OtherMED WAIVER
FL101747104Medicaid