Provider Demographics
NPI:1598412744
Name:BAYA CLINICAL SERVICES LLC
Entity type:Organization
Organization Name:BAYA CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY (AJ)
Authorized Official - Middle Name:S
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:386-288-5067
Mailing Address - Street 1:780 SE BAYA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-5403
Mailing Address - Country:US
Mailing Address - Phone:386-755-6677
Mailing Address - Fax:
Practice Address - Street 1:780 SE BAYA DR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-5403
Practice Address - Country:US
Practice Address - Phone:386-755-6677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty