NPIMap

Organization Active NPI

Barnes Drug Stores of Valdosta, Inc

Doing business as Barnes Healthcare Services

  • Durable Medical Equipment & Medical Supplies
  • Valdosta, GA
National Provider Identifier
1023099983
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
2418 Issued in GA
Legal business name
BARNES DRUG STORES OF VALDOSTA, INC
Doing business as
Barnes Healthcare Services
Practice address
200 S Patterson St
Valdosta, GA 31601-5621
Phone
(229) 245-6039
Fax
(888) 276-7881
NPI assigned
Nov 8, 2005
Last updated
May 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Charles Barnes IV
Title
Owner
Phone
(229) 245-6001

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 2418 GA Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 2418 GA
Oxygen Equipment & Supplies (DME) 332BX2000X 2418 GA
Pharmacy 333600000X 2418 GA
Home Infusion Therapy Pharmacy 3336H0001X

Addresses

Primary practice location

200 S Patterson St
Valdosta, GA 31601-5621

Mailing address

PO Box 1187
Valdosta, GA 31603-1187
Phone (229) 245-6039

Other identifiers 6

IdentifierTypeStateIssuer
00021645BMedicaidGA
00021645AMedicaidGA
090419800MedicaidFL
104473700MedicaidFL
105405500MedicaidFL
105405501MedicaidFL

Other names 1

  • Barnes Healthcare Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20100930026301 GA DME Supplier - Medical Supply Company With Registered PharmacistDME Supplier - Medical Supply CompanyDME Supplier - PharmacyDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 7214055771 Practice locations: Valdosta, GA
O20121128000441 GA Part B Supplier - Pharmacy 7214055771 Practice locations: Valdosta, GA
O20200710001880 GA Part B Supplier - Independent Clinical Laboratory 7214055771 Practice locations: Valdosta, GA
O20201125000001 GA Part B Supplier - Independent Clinical Laboratory 7214055771 Practice locations: Valdosta, GA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

801 13th Ave
Ste B
Albany, GA 31701
Phone (229) 639-0033

2030 Powers Ferry Rd SE
Ste 368
Atlanta, GA 30339
Phone (678) 627-0077

210 E 4th Ave
Cordele, GA 31015
Phone (229) 273-2939

200 S Patterson St
Valdosta, GA 31601
Phone (229) 242-1925

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1023099983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1187",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316031187",
            "telephone_number": "229-245-6039",
            "fax_number": "888-276-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316015621",
            "telephone_number": "229-245-6039",
            "fax_number": "888-276-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARNES DRUG STORES OF VALDOSTA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-245-6001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "IV"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "2418",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "GA",
            "license": "2418",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "GA",
            "license": "2418",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "2418",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00021645B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00021645A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090419800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104473700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105405500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105405501",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Barnes Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Barnes Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.