Basic Information
| Provider Information | |||||||||
| NPI: | 1235176330 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BAY HOSPITAL, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | GULF COAST MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 PARK PLZ | ||||||||
| Address2: | REGULATORY COMPLIANCE SUPPORT, BLDG. 2-3 W | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372036527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9046886550 | ||||||||
| FaxNumber: | 8507477107 | ||||||||
| Practice Location | |||||||||
| Address1: | 449 W 23RD ST | ||||||||
| Address2: | |||||||||
| City: | PANAMA CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 324054507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8507698341 | ||||||||
| FaxNumber: | 8507477107 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 03/30/2022 | ||||||||
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| AuthorizedOfficialLastName: | GOODPASTER | ||||||||
| AuthorizedOfficialFirstName: | AMBER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8507477140 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 1211641 | 05 | MA | MEDICAID |