Healthcare Provider Details

I. General information

NPI: 1578319737
Provider Name (Legal Business Name): BAY LIFE SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4390 PARLIAMENT PLACE SUITE R
LANHAM MD
20706
US

IV. Provider business mailing address

4390 PARLIAMENT PLACE SUITE R
LANHAM MD
20706
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-5728
  • Fax:
Mailing address:
  • Phone: 301-552-5728
  • Fax: 301-306-8587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: JEFFERY MATTON
Title or Position: SVP INTEGRATED OPERATIONS
Credential:
Phone: 410-772-6818