Provider Demographics
NPI:1083877435
Name:BARR MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:BARR MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:D
Authorized Official - Last Name:WARGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-731-8080
Mailing Address - Street 1:2350 W. OAKLAND PARK BOULEVARD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311
Mailing Address - Country:US
Mailing Address - Phone:954-731-8080
Mailing Address - Fax:954-731-8670
Practice Address - Street 1:2350 W. OAKLAND PARK BOULEVARD
Practice Address - Street 2:SUITE 900
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311
Practice Address - Country:US
Practice Address - Phone:954-731-8080
Practice Address - Fax:954-731-8670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
FLOS3754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL81958OtherBLUE CROSS
FL374823500Medicaid