NPIMap

Organization Active NPI

Bay Area Medical Center Inc

Doing business as Bay Area Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Marinette, WI
National Provider Identifier
1811004872
Registry record updated Apr 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
8044-042 Issued in WI
Legal business name
BAY AREA MEDICAL CENTER INC
Doing business as
Bay Area Outpatient Pharmacy
Practice address
3100 Shore Dr-
Suite Cos
Marinette, WI 54143-4242
Phone
(715) 735-8072
Fax
(715) 735-8011
NPI assigned
Aug 24, 2006
Last updated
Apr 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2013

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

Authorized official

Name
William F Taccolini
Title
Pharmacy Director
Phone
(715) 735-6621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 8044-042 WI Primary

Addresses

Primary practice location

3100 Shore Dr-
Suite Cos
Marinette, WI 54143-4242

Mailing address

3100 Shore Dr-
Suite Cos
Marinette, WI 54143-4242
Phone (715) 735-8072

Other identifiers 1

IdentifierTypeStateIssuer
33058800MedicaidWI

Other names 1

  • BAY AREA OUTPATIENT PHARMACY Doing business as

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.

Locations

3100 Shore Dr
Ste Cos
Marinette, WI 54143
Phone (715) 735-8072

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365379200000",
    "number": "1811004872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SHORE DR-",
            "address_2": "SUITE COS",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434242",
            "telephone_number": "715-735-8072",
            "fax_number": "715-735-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SHORE DR-",
            "address_2": "SUITE COS",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434242",
            "telephone_number": "715-735-8072",
            "fax_number": "715-735-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2013-04-08",
        "status": "A",
        "authorized_official_last_name": "TACCOLINI",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "715-735-6621"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8044-042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33058800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAY AREA OUTPATIENT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 8, 2013; 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.