Provider Demographics
NPI:1801916713
Name:BAYCARE HOME CARE, INC.
Entity type:Organization
Organization Name:BAYCARE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMISI
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:727-470-4609
Mailing Address - Street 1:8452 118TH AVE
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-5007
Mailing Address - Country:US
Mailing Address - Phone:727-394-6461
Mailing Address - Fax:727-394-6540
Practice Address - Street 1:4625 E BAY DR STE 105
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6866
Practice Address - Country:US
Practice Address - Phone:352-795-4495
Practice Address - Fax:352-795-1914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL410108100Medicaid