1558695684 NPI number — BAY VIEW HOMECARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558695684 NPI number — BAY VIEW HOMECARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAY VIEW HOMECARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558695684
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4404 FITCH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21236-3907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-665-0107
Provider Business Mailing Address Fax Number:
410-665-0107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 MIDDLEFORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEAFORD
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19973-3617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-629-0202
Provider Business Practice Location Address Fax Number:
302-629-9382
Provider Enumeration Date:
09/22/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ROTH
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
410-665-0107

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  09 01162 37 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 332B00000X . This is a "TAXONOMY" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com