Provider Demographics
NPI:1295098762
Name:BARNES DRUG STORES INC
Entity type:Organization
Organization Name:BARNES DRUG STORES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:229-245-6039
Mailing Address - Street 1:PO BOX 1187
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31603-1187
Mailing Address - Country:US
Mailing Address - Phone:229-245-6039
Mailing Address - Fax:888-276-7881
Practice Address - Street 1:200 S PATTERSON ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31601-5621
Practice Address - Country:US
Practice Address - Phone:229-245-6039
Practice Address - Fax:888-276-7881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy