Organization
BAY STATE MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL R SCHAUB (PRESIDENT)
(410) 859-2366
Entity
Organization
Contact information
Practice address
7271 PARK CIRCLE DR, HANOVER, MD 21076-1325
(410) 859-2366
(410) 859-3002
Mailing address
7271 PARK CIRCLE DR, HANOVER, MD 21076-1325
(410) 859-2366
(410) 859-3002
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
R1031
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025302100
—
DC
05
—
089118500
—
MD
01
—
57766
NORTHWOOD
—
01
—
F301-0001
FEDERAL BCBS
MD
01
—
Y675
CAREFIRST BCBS MD
MD
Enumeration date
06/15/2005
Last updated
04/20/2008
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