Basic Information
| Provider Information | |||||||||
| NPI: | 1811932429 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAYADA HOME HEALTH CARE, INC, | ||||||||
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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: | 643 GREENWAY RD | ||||||||
| Address2: | SUITE G | ||||||||
| City: | BOONE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286074819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282635350 | ||||||||
| FaxNumber: | 8282635354 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2006 | ||||||||
| LastUpdateDate: | 02/10/2014 | ||||||||
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| AuthorizedOfficialLastName: | FLANNERY | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF BILLING & COLLECTIONS | ||||||||
| AuthorizedOfficialTelephone: | 8567931703 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BAYADA HOME HEALTH CARE, INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 253Z00000X | HC3860 | NC | N | Agencies | In Home Supportive Care | 251J00000X | HC3860 | NC | N | Agencies | Nursing Care | 251E00000X | HC3860 | NC | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 3408428 | 05 | NC | MEDICAID | 2527159 | 01 | NC | AETNA/US HEALTHCARE | OTHER | 007AY | 01 | NC | BC/BS OF NORTH CAROLINA | OTHER | 1594 | 01 | NC | PIEDMONT | OTHER | 228865 | 01 | NC | MAMSI | OTHER | 228865 | 01 | NC | ALLIANCE | OTHER | 0076M | 01 | NC | BC/BS OF NORTH CAROLINA | OTHER | 115652 | 01 | NC | CAREMARK, INC | OTHER | 6601147 | 05 | NC | MEDICAID | 7107130 | 01 | NC | AETNA INSURANCE | OTHER |