Organization
BAY PHARMACIES INC
Active
Other names
Bayside Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC HAGEN (PRESIDENT / COO)
(920) 746-2158
Entity
Organization
Contact information
Practice address
1437 EGG HARBOR RD, STURGEON BAY, WI 54235-1239
(920) 746-2158
(920) 746-2138
Mailing address
1437 EGG HARBOR RD, STURGEON BAY, WI 54235-1239
(920) 746-2158
(920) 746-2138
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6547
WI
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
6547
WI
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
6547
WI
332BX2000X
Oxygen Equipment & Supplies (DME)
6547
WI
335E00000X
Prosthetic/Orthotic Supplier
6547
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41755000
—
WI
Enumeration date
02/13/2007
Last updated
04/19/2021
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