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Organization

BAY CITY ORTHOCARE LLC

Active
Parent organization
BAY CITY ORTHOCARE, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
BAY CITY ORTHOCARE, LLC
Authorized official
DIANE L DESARRO (ADMINISTRATIVE DIRECTOR)
(814) 452-4632
Entity
Organization

Contact information

Practice address
900 WATER ST, MEADVILLE, PA 16335-3428
(814) 332-0024
(814) 332-0029
Mailing address
2313 PEACH ST, ERIE, PA 16502-2822
(814) 452-4632
(814) 452-4636

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
6000006121
PA
335E00000X
Prosthetic/Orthotic Supplier
Primary
6000006121
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0019531980003
PA
Enumeration date
12/21/2006
Last updated
09/24/2012
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