MEDICARE: BARNABAS HEALTH SERVICES, INC.

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	207QA0505X	Adult Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386040467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARNABAS HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	1303 JASMINE ST
Second Line	:	SUITE 101
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-2992
Country	:	US
Telephone Number	:	904-261-7000
Fax Number	:	904-261-8899

Provider Business Practice Location Address
First Line	:	1303 JASMINE ST
Second Line	:	SUITE 101
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-2992
Country	:	US
Telephone Number	:	904-261-7000
Fax Number	:	904-261-8899

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. WANDA LANIER
Credential	:
Telephone Number	:	904-261-7000

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	03/30/2020

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Directions to “BARNABAS HEALTH SERVICES, INC. ” Practice Location

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