Bay Quality Prosthetics LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

POR31 Issued in FL

Legal business name

BAY QUALITY PROSTHETICS LLC

Practice address

2195 Jenks Ave Ste C
Ste D
Panama City, FL 32405-4683

Phone

(850) 522-5343

Fax

(850) 640-0901

NPI assigned

Nov 16, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Glenn CottrillNPI 1396063772

Title

Sole MBR

Phone

(850) 522-5343

Specialties & licenses 1

Addresses

Other names 1

• BAY PROSTHETIC CENTER Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Glenn Cottrill

  • Durable Medical Equipment & Medical Supplies
  • Fort Walton Beach, FL
  • NPI 1396063772
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1003117466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 JENKS AVE STE C",
            "address_2": "STE D",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054683",
            "telephone_number": "850-522-5343",
            "fax_number": "850-640-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 JENKS AVE STE C",
            "address_2": "STE D",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054683",
            "telephone_number": "850-522-5343",
            "fax_number": "850-640-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY QUALITY PROSTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "COTTRILL",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "850-522-5343",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "FL",
            "license": "POR31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAY PROSTHETIC CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Bay Plastic Surgery
• Bay Podiatry Center, PA
• Bay Radiology Associates, PL
• Bay Radiology Womens Imaging Center LLC
• Bay Radiology Womens Imaging Center, LLC
• Bay Walk in Clinic, Inc
• Abdel-Azim Bayoumy, M.D.

• Customized Equipment (DME) in Panama City, FL
• Providers in Panama City, FL by specialty
• Customized Equipment (DME) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.