Provider Demographics
NPI:1023006434
Name:BAYHEALTH MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:BAYHEALTH MEDICAL CENTER, INC.
Other - Org Name:BAYHEALTH HOSPITAL, SUSSEX CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRETINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-744-7162
Mailing Address - Street 1:100 WELLNESS WAY
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-4364
Mailing Address - Country:US
Mailing Address - Phone:302-430-5738
Mailing Address - Fax:302-744-7181
Practice Address - Street 1:100 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-4364
Practice Address - Country:US
Practice Address - Phone:302-430-5738
Practice Address - Fax:302-735-3842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QU0200X
DEHSPTL-006282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE67005Medicaid
DE67406Medicaid
DE166873Medicare PIN
DE67406Medicaid
DEG00746Medicare PIN
DE165135Medicare PIN
080009Medicare Oscar/Certification
DEG02448Medicare PIN
DE165124Medicare PIN
DE165141Medicare PIN