Provider Demographics
NPI:1164819884
Name:BAYADA HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:BAYADA HOME HEALTH CARE, INC.
Other - Org Name:BAYADA PRIMARY CARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BILLING & COLLECTIONS
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:FLANNERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-778-4400
Mailing Address - Street 1:101 EXECUTIVE DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-4236
Mailing Address - Country:US
Mailing Address - Phone:856-778-4400
Mailing Address - Fax:856-778-4103
Practice Address - Street 1:6311 ATRIUM DR
Practice Address - Street 2:SUITE 206
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-4143
Practice Address - Country:US
Practice Address - Phone:941-746-8056
Practice Address - Fax:941-746-2969
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYADA HOME HEALTH CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-21
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107776Medicare Oscar/Certification