Provider Demographics
NPI:1558695684
Name:BAY VIEW HOMECARE, INC.
Entity Type:Organization
Organization Name:BAY VIEW HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-665-0107
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:410-665-0107
Practice Address - Street 1:1601 MIDDLEFORD RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3617
Practice Address - Country:US
Practice Address - Phone:302-629-0202
Practice Address - Fax:302-629-9382
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY VIEW HOMECARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-22
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE09 01162 37332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
332B00000XOtherTAXONOMY
0186380002Medicare NSC