Provider Demographics
NPI:1043307663
Name:BAY PHARMACY, INC.
Entity Type:Organization
Organization Name:BAY PHARMACY, INC.
Other - Org Name:BAY INSTITUTIONAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:ADKISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-357-4341
Mailing Address - Street 1:2 E MAGNOLIA AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-3417
Mailing Address - Country:US
Mailing Address - Phone:352-357-4341
Mailing Address - Fax:357-357-5107
Practice Address - Street 1:2 E MAGNOLIA AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-3417
Practice Address - Country:US
Practice Address - Phone:352-357-4341
Practice Address - Fax:357-357-5107
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 186023336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL032067600Medicaid
FL1012979OtherNCPDP
FL1012979OtherNCPDP
FL032067600Medicaid