NPIMap

Organization Active NPI

Bay Pharmacies Inc

Doing business as Bayside Home Medical

  • Durable Medical Equipment & Medical Supplies
  • Appleton, WI
National Provider Identifier
1518442771
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BAY PHARMACIES INC
Doing business as
Bayside Home Medical
Practice address
1717 E Calumet St Unit C
Appleton, WI 54915-4079
Phone
(920) 746-2158
Fax
(920) 746-2138
NPI assigned
Oct 3, 2018
Organization subpart
Yes
Parent organization
BAY PHARMACIES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Authorized official

Name
Mr. Eric Hagen
Title
President/Coo
Phone
(920) 746-2158

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1717 E Calumet St Unit C
Appleton, WI 54915-4079

Mailing address

1300 Egg Harbor Rd Ste 112
Sturgeon Bay, WI 54235-1248
Phone (920) 746-2158

Other identifiers 1

IdentifierTypeStateIssuer
100075677MedicaidWI

Other names 1

  • Bayside Home Medical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bay Pharmacies Inc3 organizations share this tax ID, including this one
Part of
Bay Pharmacies Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1518442771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 EGG HARBOR RD STE 112",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351248",
            "telephone_number": "920-746-2158",
            "fax_number": "920-746-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 E CALUMET ST UNIT C",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154079",
            "telephone_number": "920-746-2158",
            "fax_number": "920-746-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY PHARMACIES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAY PHARMACIES INC",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "HAGEN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT/COO",
        "authorized_official_telephone_number": "920-746-2158",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100075677",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayside Home Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.