Provider Demographics
NPI:1346201506
Name:BAY VIEW HOMECARE INC
Entity Type:Organization
Organization Name:BAY VIEW HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-463-8900
Mailing Address - Street 1:4404 FITCH AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-3907
Mailing Address - Country:US
Mailing Address - Phone:410-665-0107
Mailing Address - Fax:410-665-0875
Practice Address - Street 1:4404 FITCH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-3907
Practice Address - Country:US
Practice Address - Phone:410-665-0107
Practice Address - Fax:410-665-0875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR940332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD235738100Medicaid
MD1122643OtherFDA LABELER 057999
MD235738100Medicaid