Provider Demographics
NPI:1821097627
Name:BAYCARE HOME CARE, INC.
Entity Type:Organization
Organization Name:BAYCARE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESDIENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-395-2047
Mailing Address - Street 1:8452 118TH AVENUE NORTH
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-5007
Mailing Address - Country:US
Mailing Address - Phone:727-394-6461
Mailing Address - Fax:727-394-6540
Practice Address - Street 1:1450 E NORTH BLVD
Practice Address - Street 2:UNIT 8 & 9
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5398
Practice Address - Country:US
Practice Address - Phone:352-728-5598
Practice Address - Fax:352-728-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA20548096251E00000X
FL20548096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008695200Medicaid
FL10-7398Medicare PIN
FL107398Medicare PIN