Provider Demographics
NPI:1134801806
Name:BAY AREA HOME HEALTH OPERATIONS LLC
Entity type:Organization
Organization Name:BAY AREA HOME HEALTH OPERATIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-269-5454
Mailing Address - Street 1:650 ANDERSON AVE STE 650
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-1672
Mailing Address - Country:US
Mailing Address - Phone:541-269-5454
Mailing Address - Fax:541-269-2828
Practice Address - Street 1:650 ANDERSON AVE STE 650
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-1672
Practice Address - Country:US
Practice Address - Phone:541-269-5454
Practice Address - Fax:541-269-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health