Healthcare Provider Details

I. General information

NPI: 1225320773
Provider Name (Legal Business Name): BAY HOME MEDICAL SERIVCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 NICHOLS AVE. EXTENSION
FAIRHOPE AL
36532-3684
US

IV. Provider business mailing address

406 MEDICAL CENTER DR.
JASPER AL
35501-3400
US

V. Phone/Fax

Practice location:
  • Phone: 251-990-3941
  • Fax: 251-990-3948
Mailing address:
  • Phone: 205-221-8200
  • Fax: 205-221-8270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LISA J. WELLS
Title or Position: EXECUTIVE DIRECTOR
Credential: CPCD
Phone: 205-221-8258