Provider Demographics
NPI:1447525423
Name:BAYVIEW HOSPICE LLC
Entity type:Organization
Organization Name:BAYVIEW HOSPICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-387-5500
Mailing Address - Street 1:605 BRADLEY RD
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-1670
Mailing Address - Country:US
Mailing Address - Phone:440-328-8141
Mailing Address - Fax:440-327-6172
Practice Address - Street 1:605 BRADLEY RD
Practice Address - Street 2:
Practice Address - City:BAY VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44140-1670
Practice Address - Country:US
Practice Address - Phone:440-328-8141
Practice Address - Fax:440-327-6172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0079815Medicaid