Organization
BAY CITY ORTHOCARE LLC
Active
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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