1568466209 NPI number — BAYVIEW MEDICAL CENTER, INC

Table of content: (NPI 1568466209)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568466209 NPI number — BAYVIEW MEDICAL CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAYVIEW MEDICAL CENTER, 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:
LMC AMBULATORY SURGERY CENTER
Provider Other Organization Name Type Code:
3
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:
1568466209
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7068
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23707-0068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-686-3508
Provider Business Mailing Address Fax Number:
757-686-0541

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 MEADE PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUFFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23434-4259
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-934-9329
Provider Business Practice Location Address Fax Number:
757-923-9648
Provider Enumeration Date:
06/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
CETRONE
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
757-686-3508

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  OH660 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0721098 . This is a "CIGNA #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 227048 . This is a "ANTHEM BCBS #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7600097 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4909895 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 655693 . This is a "NCPPO #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 490002226 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 556665 . This is a "MAMSI #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com