Basic Information
Provider Information
NPI: 1770514226
EntityType: 2
ReplacementNPI:  
OrganizationName: BAYADA HOME HEALTH CARE, INC.
LastName:  
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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: 212 LE PHILLIP CT
Address2: SUITE 202
City: CONCORD
State: NC
PostalCode: 280252984
CountryCode: US
TelephoneNumber: 7047955000
FaxNumber: 7047955025
Other Information
ProviderEnumerationDate: 07/05/2006
LastUpdateDate: 02/10/2014
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: FLANNERY
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: DIRECTOR OF BILLING & COLLECTIONS
AuthorizedOfficialTelephone: 8567931703
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: BAYADA HOME HEALTH CARE, INC.
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
253Z00000XHC3467NCN AgenciesIn Home Supportive Care 
251J00000XHC3467NCN AgenciesNursing Care 
251E00000XHC3467NCY AgenciesHome Health 

ID Information
IDTypeStateIssuerDescription
11565201NCCAREMARK, INCOTHER
007AY01NCBC/BS OF NORTH CAROLINAOTHER
22886501NCALLIANCEOTHER
22886501NCMAMSIOTHER
710713001NCAETNA INSURANCEOTHER
660154505NC MEDICAID
710059105NC MEDICAID
252715901NCAETNA/US HEALTHCAREOTHER
0076M01NCBC/BS OF NORTH CAROLINAOTHER
159401NCPIEDMONTOTHER
340842805NC MEDICAID


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