MEDICARE: BARTOW HEALTH ACCESS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QH0100X	Health Service Clinic/Center
2	261QP2300X	Primary Care Clinic/Center
3	291U00000X	Clinical Medical Laboratory
4	261QC1500X	Community Health Clinic/Center

General Provider Information

NPI Number	:	1316286842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARTOW HEALTH ACCESS, INC.

Provider Business Mailing Address
First Line	:	31 POINTE NORTH DRIVE
Second Line	:
City	:	CARTERSVILLE
State	:	GA
Zip	:	30120
Country	:	US
Telephone Number	:	678-535-7216
Fax Number	:	678-535-7227

Provider Business Practice Location Address
First Line	:	31 POINTE NORTH DR
Second Line	:
City	:	CARTERSVILLE
State	:	GA
Zip	:	30120-7954
Country	:	US
Telephone Number	:	678-535-7216
Fax Number	:	678-535-7227

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. ROBERTA R GREEN
Credential	:
Telephone Number	:	678-535-7216

Provider Enumeration Date	:	02/04/2013
Last Update Date	:	02/04/2013

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