MEDICARE: BAYCARE HOME CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336S0011X	Specialty Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
4	333600000X	Pharmacy
5	3336H0001X	Home Infusion Therapy Pharmacy
6	3336C0004X	Compounding Pharmacy	PH19055	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2011973	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225090087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYCARE HOME CARE, INC.

Provider Business Mailing Address
First Line	:	8452 118TH AVE
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33773-5007
Country	:	US
Telephone Number	:	727-394-6585
Fax Number	:	727-394-6540

Provider Business Practice Location Address
First Line	:	8452 118TH AVE
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33773-5007
Country	:	US
Telephone Number	:	727-394-6585
Fax Number	:	727-394-6540

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. TIMISI C JOHNSON
Credential	:	RN
Telephone Number	:	727-470-4609

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	06/17/2025

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Directions to “BAYCARE HOME CARE, INC. ” Practice Location

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