| Bayside House Call Group Llc | |
|
2 E 14th St Ocean City NJ 08226-3102 | |
| (800) 513-3680 | |
| (888) 503-8365 |
| Full Name | Bayside House Call Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2 E 14th St, Ocean City, New Jersey |
| Authorized Official Name and Position | James D Lavis (PRESIDENT) |
| Authorized Official Contact | 8005133680 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayside House Call Group Llc 2 E 14th St Ocean City NJ 08226-3102 Ph: (800) 513-3680 | Bayside House Call Group Llc 2 E 14th St Ocean City NJ 08226-3102 Ph: (800) 513-3680 |
| NPI Number | 1942594759 |
|---|---|
| Provider Enumeration Date | 06/09/2011 |
| Last Update Date | 07/19/2011 |
| Medicare PECOS PAC ID | 1153599840 |
|---|---|
| Medicare Enrollment ID | O20110725000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942594759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 25MB03241600 (New Jersey) | Primary |
| Provider Name | James D Lavis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992783609 PECOS PAC ID: 5597753806 Enrollment ID: I20050421000927 |
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