Healthcare Provider Details

I. General information

NPI: 1609275924
Provider Name (Legal Business Name): BARNES HEALTHCARE OF FL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2014
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5483 W WATERS AVE SUITE 1200 N
TAMPA FL
33634-1205
US

IV. Provider business mailing address

PO BOX 160
VALDOSTA GA
31603-0160
US

V. Phone/Fax

Practice location:
  • Phone: 229-245-6039
  • Fax:
Mailing address:
  • Phone: 229-245-6039
  • Fax: 888-276-7881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHARLES W BARNES III
Title or Position: CEO/OWNER
Credential: RPH
Phone: 229-245-6039