Provider Demographics
NPI:1205310935
Name:BAY MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:BAY MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEM MGR.
Authorized Official - Prefix:
Authorized Official - First Name:PAVANI
Authorized Official - Middle Name:
Authorized Official - Last Name:MADIRAJU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-501-7959
Mailing Address - Street 1:10335 CROSS CREEK BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2643
Mailing Address - Country:US
Mailing Address - Phone:813-501-7959
Mailing Address - Fax:800-763-5765
Practice Address - Street 1:10335 CROSS CREEK BLVD STE G
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2643
Practice Address - Country:US
Practice Address - Phone:813-501-7959
Practice Address - Fax:800-763-5765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies