Provider Demographics
NPI:1669551198
Name:BAYHEALTH MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:BAYHEALTH MEDICAL CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE-PRESIDENT, CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRETINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-744-7162
Mailing Address - Street 1:100 WELLNESS WAY
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-4364
Mailing Address - Country:US
Mailing Address - Phone:302-430-5347
Mailing Address - Fax:
Practice Address - Street 1:100 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-4364
Practice Address - Country:US
Practice Address - Phone:302-430-5347
Practice Address - Fax:302-430-5744
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYHEALTH MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-03
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
08T009Medicare Oscar/Certification