Provider Demographics
NPI:1578212221
Name:BAYSIDE SITTERS
Entity Type:Organization
Organization Name:BAYSIDE SITTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-229-1096
Mailing Address - Street 1:574 AZALEA RD STE 106
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1517
Mailing Address - Country:US
Mailing Address - Phone:251-229-1096
Mailing Address - Fax:
Practice Address - Street 1:574 AZALEA RD STE 106
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-1517
Practice Address - Country:US
Practice Address - Phone:251-229-1096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory