MEDICARE: BARTON HEALTHCARE SYSTEM

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	1985HHA-13	NV
2	251E00000X	Home Health Agency	100000174	CA

General Provider Information

NPI Number	:	1356348890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARTON HEALTHCARE SYSTEM

Provider Business Mailing Address
First Line	:	2092 LAKE TAHOE BLVD
Second Line	:	#500
City	:	SOUTH LAKE TAHOE
State	:	CA
Zip	:	96150-6422
Country	:	US
Telephone Number	:	530-543-5581
Fax Number	:	530-541-2653

Provider Business Practice Location Address
First Line	:	2092 LAKE TAHOE BLVD STE 500
Second Line	:
City	:	SOUTH LAKE TAHOE
State	:	CA
Zip	:	96150-6429
Country	:	US
Telephone Number	:	530-543-5581
Fax Number	:	530-541-2653

Authorized Official
Title or Position	:	CEO
Name	:	MR. CLINTON PURVANCE
Credential	:	MD
Telephone Number	:	530-541-3420

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	08/17/2023

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Directions to “BARTON HEALTHCARE SYSTEM ” Practice Location

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