Basic Information
| Provider Information | |||||||||
| NPI: | 1003122995 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BAYADA HOME HEALTH CARE, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BAYADA PEDIATRICS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 EXECUTIVE DR | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080574236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567784400 | ||||||||
| FaxNumber: | 8567784103 | ||||||||
| Practice Location | |||||||||
| Address1: | 1145 HWY 80 W | ||||||||
| Address2: | SUITE H | ||||||||
| City: | POOLER | ||||||||
| State: | GA | ||||||||
| PostalCode: | 313222200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123309300 | ||||||||
| FaxNumber: | 9123309400 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2010 | ||||||||
| LastUpdateDate: | 01/23/2012 | ||||||||
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| AuthorizedOfficialLastName: | FLANNERY | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | P. | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR BILLING AND COLLECTIONS | ||||||||
| AuthorizedOfficialTelephone: | 8567784400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BAYADA HOME HEALTH CARE, INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
No ID Information.