Healthcare Provider Details

I. General information

NPI: 1447845177
Provider Name (Legal Business Name): NORTH BAY HOME HEALTH CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2021
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13361 N 56TH ST STE E
TAMPA FL
33617-1161
US

IV. Provider business mailing address

1101 RAY CHARLES BLVD UNIT 1505
TAMPA FL
33602-3019
US

V. Phone/Fax

Practice location:
  • Phone: 813-605-8284
  • Fax: 888-965-9978
Mailing address:
  • Phone: 336-926-0133
  • Fax: 888-965-9978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL BAPTISTE
Title or Position: OWNER
Credential:
Phone: 336-926-0133