Provider Demographics
NPI:1376546366
Name:COUNTY OF BAY
Entity Type:Organization
Organization Name:COUNTY OF BAY
Other - Org Name:BAY COUNTY MEDICAL CARE FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:MACALPINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-892-3591
Mailing Address - Street 1:564 W HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:ESSEXVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48732-9710
Mailing Address - Country:US
Mailing Address - Phone:989-892-3591
Mailing Address - Fax:989-892-6991
Practice Address - Street 1:564 W HAMPTON RD
Practice Address - Street 2:
Practice Address - City:ESSEXVILLE
Practice Address - State:MI
Practice Address - Zip Code:48732-9710
Practice Address - Country:US
Practice Address - Phone:989-892-3591
Practice Address - Fax:989-892-6991
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY COUNTY MEDICAL CARE FACILITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-05-24
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI098510314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI09567OtherBCBS OF MI
MI2085123Medicaid
MI690353780OtherSTATE I.D.
MI0Z97608Medicare ID - Type UnspecifiedMEDICARE PART B
MI09567OtherBCBS OF MI