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General NPI Number Information
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NPI Number | 1104244706
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Entity Type | Organization
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Legal Business Name | BARTOW HEALTH ACCESS
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Dates
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Enumeration Date | 04/01/2014
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Last Update Date | 04/01/2014
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Provider Practice Location Address
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Address Line | 31 POINTE NORTH DR
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City | CARTERSVILLE
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State | GA
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Zip | 30120-7954
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Country | US
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Telephone | 678-535-7216
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Fax | 678-535-7227
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Provider Business Mailing Address
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Address Line | 31 POINTE NORTH DR
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City | CARTERSVILLE
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State | GA
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Zip | 30120-7954
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Country | US
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Telephone | 678-535-7216
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Fax | 678-535-7227
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. GARY LAWRENCE JAMES
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Credential |
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Telephone | 678-535-7216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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