Provider Demographics
NPI:1982068847
Name:BAY MANOR NURSING HOME, INC.
Entity Type:Organization
Organization Name:BAY MANOR NURSING HOME, INC.
Other - Org Name:FUTURECARE CHESAPEAKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FINGALSS
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:410-766-1995
Mailing Address - Street 1:8028 RITCHIE HWY
Mailing Address - Street 2:SUITE 210B
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-1075
Mailing Address - Country:US
Mailing Address - Phone:410-766-1995
Mailing Address - Fax:410-761-6095
Practice Address - Street 1:305 COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2912
Practice Address - Country:US
Practice Address - Phone:410-647-0015
Practice Address - Fax:410-647-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02-004314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7006021 00Medicaid
MD7006021 00Medicaid