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General NPI Number Information
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NPI Number | 1467606657
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Entity Type | Organization
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Legal Business Name | BARTON HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 09/19/2012
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Provider Practice Location Address
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Address Line | 2170 SOUTH AVE
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-7026
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Country | US
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Telephone | 530-541-3420
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Fax | 530-541-2512
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Provider Business Mailing Address
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Address Line | PO BOX 9578
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96158-9578
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Country | US
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Telephone | 530-541-3420
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Fax | 530-541-2512
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Authorized Official
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Title or Position | CFO
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Name | RICHARD PAUL DERBY
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Credential |
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Telephone | 530-543-5841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | HSP21312
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License Number State | CA
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