NPIMap

Organization Active NPI

Bay Area Medical Center Inc

  • Pharmacy
  • Marinette, WI
National Provider Identifier
1770660805
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
6698 Issued in WI
Legal business name
BAY AREA MEDICAL CENTER INC
Practice address
3100 Shore Drive
Marinette, WI 54143-4242
Phone
(715) 735-4200
Fax
(715) 735-1791
NPI assigned
Nov 1, 2006
Last updated
Apr 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
C Danial Carlson, CPA
Title
Cfo
Phone
(715) 735-8016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 6698 WI Primary

Addresses

Primary practice location

3100 Shore Drive
Marinette, WI 54143-4242

Mailing address

3100 Shore Drive
Marinette, WI 54143-4242
Phone (715) 735-4200

Other identifiers 3

IdentifierTypeStateIssuer
1711544MedicaidMI
11001400MedicaidWI
1711526MedicaidMI

Other names 1

  • Bay Area Medical Center Inc Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Bay Area Med Ctr Crnas13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1770660805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SHORE DRIVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434242",
            "telephone_number": "715-735-4200",
            "fax_number": "715-735-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SHORE DRIVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434242",
            "telephone_number": "715-735-4200",
            "fax_number": "715-735-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "DANIAL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "715-735-8016",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WI",
            "license": "6698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1711544",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11001400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1711526",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Area Medical Center Inc Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.