Healthcare Provider Details

I. General information

NPI: 1689147043
Provider Name (Legal Business Name): BAY MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2019
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 CHARLES STREET SUITE 101
LAPLATA MD
20646
US

IV. Provider business mailing address

211 CHARLES STREET SUITE 101
LAPLATA MD
20640
US

V. Phone/Fax

Practice location:
  • Phone: 301-855-8199
  • Fax: 301-855-3448
Mailing address:
  • Phone: 301-855-8199
  • Fax: 301-855-3448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL P HERRON
Title or Position: CTO
Credential:
Phone: 301-855-8199