Organization
BAY HOME MEDICAL & REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUANE RICKEBERG (OPERATIONS MANAGER)
(231) 933-1200
Entity
Organization
Contact information
Practice address
525 COUNTY RD HQ, MARQUETTE, MI 49855
(906) 225-1135
(906) 225-5035
Mailing address
707 PARSONS RD, TRAVERSE CITY, MI 49686
(231) 933-1200
(231) 933-4402
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
MI
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0951920003
—
MI
05
—
3124084
—
MI
01
—
540B80747
BLUE CROSS BLUE SHIELD
MI
Enumeration date
09/23/2005
Last updated
07/21/2022
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