Provider Demographics
NPI:1578319737
Name:BAY LIFE SERVICES CORPORATION
Entity type:Organization
Organization Name:BAY LIFE SERVICES CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP INTEGRATED OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-772-6818
Mailing Address - Street 1:4390 PARLIAMENT PLACE
Mailing Address - Street 2:SUITE R
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706
Mailing Address - Country:US
Mailing Address - Phone:301-552-5728
Mailing Address - Fax:301-306-8587
Practice Address - Street 1:4390 PARLIAMENT PLACE
Practice Address - Street 2:SUITE R
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:301-552-5728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC035190017Medicaid