Healthcare Provider Details

I. General information

NPI: 1770514226
Provider Name (Legal Business Name): BAYADA HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 LE PHILLIP CT SUITE 202
CONCORD NC
28025-2984
US

IV. Provider business mailing address

101 EXECUTIVE DR SUITE 4
MOORESTOWN NJ
08057-4236
US

V. Phone/Fax

Practice location:
  • Phone: 704-795-5000
  • Fax: 704-795-5025
Mailing address:
  • Phone: 856-778-4400
  • Fax: 856-778-4103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC3467
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHC3467
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC3467
License Number StateNC

VIII. Authorized Official

Name: STEPHEN P FLANNERY
Title or Position: DIRECTOR OF BILLING & COLLECTIONS
Credential:
Phone: 856-793-1703