MEDICARE: BAY AREA HOSPITAL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency
2	251E00000X	Home Health Agency	13141024	OR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	H3814	OTHER	OR	MY ADVANTAGE MEDICARE HMO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	3010	OTHER	OR	OHP MANAGED CARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215018197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	3950 SHERMAN AVENUE
Second Line	:
City	:	NORTH BEND
State	:	OR
Zip	:	97459-2872
Country	:	US
Telephone Number	:	541-269-5454
Fax Number	:	541-269-4665

Provider Business Practice Location Address
First Line	:	3950 SHERMAN AVENUE
Second Line	:
City	:	NORTH BEND
State	:	OR
Zip	:	97459-2872
Country	:	US
Telephone Number	:	541-269-5454
Fax Number	:	541-269-4665

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	SAMUEL PATTERSON
Credential	:
Telephone Number	:	541-269-8130

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	03/15/2021

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Directions to “BAY AREA HOSPITAL DISTRICT ” Practice Location

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