Basic Information
Provider Information
NPI: 1588088165
EntityType: 2
ReplacementNPI:  
OrganizationName: BAYADA HOME HEALTH CARE, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 101 EXECUTIVE DR
Address2:  
City: MOORESTOWN
State: NJ
PostalCode: 080574236
CountryCode: US
TelephoneNumber: 8567784400
FaxNumber: 8567784103
Practice Location
Address1: 25 WOODS LAKE RD
Address2: SUITE 305
City: GREENVILLE
State: SC
PostalCode: 296076125
CountryCode: US
TelephoneNumber: 8642421211
FaxNumber: 8642422021
Other Information
ProviderEnumerationDate: 02/18/2014
LastUpdateDate: 02/18/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: FLANNERY
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIRECTOR OF BILLING AND COLLECTIONS
AuthorizedOfficialTelephone: 8567784400
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: BAYADA HOME HEALTH CARE, INC.
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X SCY AgenciesHome Health 

No ID Information.


Home