Healthcare Provider Details

I. General information

NPI: 1558581215
Provider Name (Legal Business Name): BARNES HEALTHCARE OF FL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BROOKMEADE DR
CRESTVIEW FL
32539
US

IV. Provider business mailing address

PO BOX 1187
VALDOSTA GA
31603-1187
US

V. Phone/Fax

Practice location:
  • Phone: 850-683-0888
  • Fax: 850-683-1688
Mailing address:
  • Phone: 229-245-6001
  • Fax: 888-276-7881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: CHARLES W BARNES IV
Title or Position: OWNER AND CEO
Credential:
Phone: 229-245-6001