Provider Demographics
NPI:1326032236
Name:BAY HOME MEDICAL & REHAB, INC.
Entity Type:Organization
Organization Name:BAY HOME MEDICAL & REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:CRTS
Authorized Official - Phone:231-933-1200
Mailing Address - Street 1:707 PARSONS RD
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-3587
Mailing Address - Country:US
Mailing Address - Phone:231-933-1200
Mailing Address - Fax:231-933-4402
Practice Address - Street 1:2250 W M 32
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-9282
Practice Address - Country:US
Practice Address - Phone:989-705-2111
Practice Address - Fax:989-705-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540B80747OtherBLUE CROSS BLUE SHIELD
MI3124084Medicaid
MI0951920002Medicare PIN