Provider Demographics
NPI:1609827856
Name:BAY COUNTY HEALTH SYSTEM LLC
Entity Type:Organization
Organization Name:BAY COUNTY HEALTH SYSTEM LLC
Other - Org Name:BAY MEDICAL ER PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-747-6909
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0895
Mailing Address - Country:US
Mailing Address - Phone:888-313-5258
Mailing Address - Fax:205-313-5245
Practice Address - Street 1:615 N BONITA AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3623
Practice Address - Country:US
Practice Address - Phone:888-313-5258
Practice Address - Fax:205-313-5245
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY COUNTY HEALTH SYSTEM LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-12
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056445100Medicaid
FL98513OtherBCBS GRP #
FL371451176OtherTRICARE GROUP#
FL98513Medicare ID - Type Unspecified